Dilemma about a patient who want to die

Last year, I worked in a clinic in the pneumology domain. Most of my patients were chronic and returned several times at the clinic. One of my patients suffered of COPD and it was the third time that I treated him. We had very good contacts. In the first two stays at the clinic, the patient was jovial and motivated. But when the patient come for the third time, he was depressed because he had a lot of difficulties to breath. The dyspnoea increased more and more and it was difficult for the patient to move. One day, the patient told me that he didn’t want to live anymore and that he wanted to take EXIT, an association for the assisted suicide. I was really sad and I was convinced that the patient could still progress.

My ethical dilemma was: do I have to respect the choice of the patient and stop the therapy? or do I have to try to convince the patient that he can still progress?

What do you think about this dilemma?  

Advertisements

2 Replies to “Dilemma about a patient who want to die”

  1. Hi Chloe. This really is a difficult subject, especially since as therapists we are not trained to provide the kind of psychological support that these patients really need. In many cases it may simply be that the patient is feeling depressed and that counseling with a psychologist may help. However, if they truly are thinking of assisted dying, I’m not sure how much a physiotherapist can offer, other than basic emotional and psychological support.

    There are some additional resources on the topics page of the course website (https://iepcourse.wordpress.com/topics/meaningful-life-and-death/), which you may find useful in reading. I’m also actually busy reading “On Being Mortal”, by Atul Gawande, which is about accepting our mortality while also trying to learn how to live a good life (http://atulgawande.com/book/being-mortal/).

    Like

  2. Hi Chloe
    This must have been a really bad experience for you and I am sorry that you had to go through it. We are taught that we need to always respect our patients wishes even if it isn’t the same choice we would make.
    Sometimes to make myself understand why a patient would make a certain choice I would put myself in that person’s shoes to understand why they feel the way they do. There is nothing we can do if someone wants to die except to refer them to a psychologist. Since you guys have become so close what you can also do is to just be there for your patient. Even if your treatment session is just you spending time with him I am sure he would feel much better after that instead of having an intense physiotherapy session that he didn’t want in the first place.
    I read through these three articles and I think it will give you the answers you are looking for.
    https://www.ausmed.com/articles/when-a-patient-refuses-assistance/
    https://www.acoi.org/StarrPass/Gomez.pdf
    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1335174/pdf/cmaj00239-0029.pdf

    Good luck with the rest of your year. Hope the above articles help you.

    Like

Leave a Reply

Please log in using one of these methods to post your comment:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out / Change )

Twitter picture

You are commenting using your Twitter account. Log Out / Change )

Facebook photo

You are commenting using your Facebook account. Log Out / Change )

Google+ photo

You are commenting using your Google+ account. Log Out / Change )

Connecting to %s