Differentiating suicide from life-ending acts and end-of-life decisions: A model based on chronic kidney disease and dialysis

John Michael Bostwick, Lewis M. Cohen

Research output: Contribution to journalArticle

23 Scopus citations

Abstract

Background: Technological advances continue to yield life-prolonging treatments that complicate the occurrence of death. Until recently, refusal to submit to recommended care was considered suicide. Objective: Physicians must now decide how to respond to requests for hastened dying. Method: The authors propose a four-square grid distinguishing true suicide from behaviors such as treatment termination and lethal noncompliance. Results: One axis characterizes whether actions hasten death. The other identifies how the patient's social and medical network collaborate in the decision-making process. Conclusion: Using chronic kidney disease to model intent and collaboration, treatment is framed within a paradigm that reflects both end-of-life decision-making complexities and contemporary conceptualizations of suicide.

Original languageEnglish (US)
Pages (from-to)1-7
Number of pages7
JournalPsychosomatics
Volume50
Issue number1
DOIs
StatePublished - Jan 1 2009

ASJC Scopus subject areas

  • Arts and Humanities (miscellaneous)
  • Applied Psychology
  • Psychiatry and Mental health

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