The Escape

It was going to be another routine assessment. The workload of psychiatrists had increased steadily ever since euthanasia was legalized several months ago. What started off as an occasional referral from a palliative care setting had gradually turned into a steady stream of requests from other departments as well.

The Euthanasia Specific Competency Assessment and Psychiatric Examination (ESCAPE) consisted of a structured questionnaire and mental state examination. Like most medical forms, it was several pages long and had to be completed in triplicate. I had been called to see a 31-year-old woman with secondary carcinoma in the brain from breast primary carcinoma. Basically, all I had to do was certify that the patient in question was not clinically depressed and was capable of making a decision. Although the legislation had been in effect for 8 months, many physicians and psychiatrists were unwilling to get involved, and it was left to a few of us who were progressive enough to consider euthanasia a viable option to do the assessments.

Having always believed that the right to die was as important as any other right, I had no qualms about being the psychiatrist on the Hospital Euthanasia Committee. Not that there was much competition for that position, anyway. To me, it was a small step from withdrawal …