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Cited by 16Palliative Care and End-of-Life IssuesSuicide and Self-Harm StudiesPalliative and Oncologic Care

Suicide Attempt After Determination of Ineligibility for Assisted Death: A Case Series

Open access
Isenberg-Grzeda, Elie, Bean, Sally, Cohen, Carole, Selby, Debbie·2020·Journal of Pain and Symptom Management
DOI 10.1016/j.jpainsymman.2020.02.016
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Abstract

Medical assistance in dying (MAID) and similar right-to-die laws are becoming increasingly common in jurisdictions across North America and elsewhere. To be eligible for MAID in Canada, requesters must have a serious illness, intolerable suffering, and a reasonably foreseeable natural death. They must also undergo two assessments to confirm eligibility. Although a growing body of literature now exists to help clinicians understand and support patients around requests for assisted death, a dearth of literature exists on how best to support those patients who are deemed ineligible. Here, we report on a case series of three patients who attempted suicide after being found ineligible for MAID. Two patients were ineligible because they did not appear to have reasonably foreseeable natural death. The third patient was ineligible because of concerns around decisional capacity. All three cases had previous diagnoses of depressive disorders and mild cognitive impairment, and two cases had histories of suicide attempts. In at-risk patients, we speculate that the period surrounding a finding of MAID ineligibility may represent a period of particular vulnerability. Clinicians must be vigilant and prepared for the possibility of heightened risk, including risk of self-harm, after a finding of ineligibility for assisted death.

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Authors
Isenberg-Grzeda, E., Bean, S., Cohen, C., & Selby, D.
Affiliations
Sunnybrook Health Science Centre (CA)
ORCID
Venue
Journal of Pain and Symptom Management
Publisher
Elsevier BV
Published
2020-07
Volume
60
Issue
1
Pages
158-163
ISSN
0885-3924 (ISSN-L)
DOI
10.1016/j.jpainsymman.2020.02.016
OpenAlex
W3008031396
Cited by
16
References
16
Citations by year
2026: 4 · 2025: 3 · 2024: 2 · 2023: 2 · 2022: 2 · 2021: 3
FWCI
1.31
Type
journal article
Language
en
Open access
Licence
Locations
  • Journal of Pain and Symptom Management (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Palliative Care and End-of-Life Issues
  • Social Sciences › Psychology › Clinical Psychology › Suicide and Self-Harm Studies
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Palliative and Oncologic Care
Keywords
medical assistance in dying, suicide attempts, decision-making capacity, depressive disorders, mild cognitive impairment, self-harm risk, patient support, end-of-life care
MeSH terms
Canada, Humans, Research, Suicide, Attempted, Suicide, Assisted

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