Suicide, Euthanasia and AIDS
Abstract
This article critically reviews research on suicide, AIDS, and HIV seropositivity. Studies indicate that men with a diagnosis of AIDS or HIV seropositivity have up to 36 times greater risk of suicide than men without the diagnosis. Yet few studies controlled for independent risk factors such as premorbid or comorbid psychiatric syndromes. Also, control groups may not be appropriate, little data are available on women, and explanations of suicidal dynamics are mostly speculative. After a look at the research on the desire for euthanasia and assisted suicide with other illnesses, the author suggests alternative hypotheses concerning suicidality, the desire for euthanasia, and AIDS.
References
Treatment refusal in medical hospitals. In Report of the President's Commission for the Study of Ethical Problems in Medicine and Biomedical and Behavioral Research. Washington, DC: US Government Printing Office (1982).
Fear of AIDS and suicide in Finland: A review. AIDS CARE, (1995). 7 (supplement 2), S187–S197
Research in psychopathology in patients with HIV/AIDS and psychiatric services in Spain. AIDS CARE, (1996). 8(2), 233–239
Physical symptoms and depressive symptoms among individuals with HIV infection. Psychosomatics, (1992). 33(4), 416–427
Suicide and cancer: 1. Demographic and social characteristics of cancer patients who committed suicide in Sweden 1973-1976. Journal of Psychosocial Oncology, (1985). 3, 17–30
Is it normal for terminally ill patients to desire death?. American Journal of Psychiatry, (1986). 143, 208–211
Impact of the human immunodeficiency virus epidemic on mortality trends in young men, United States. American Journal of Public Health, (1990). 80, 1080–1086
AIDS and suicide issues in Spain. AIDS CARE, (1995). 7(supplement 2), S135–S138
Correlazioni fra profilo sierologico HIV, psicopatologia e risposta al trattamento nelle tosscodipendenze da eroina. Rivista Psichiatrica, (1990). 25, 71–86
Character of terminal illness in the advanced cancer patient: Pain and other symptoms during the last four weeks of life. Journal of Pain and Symptom Management, (1990). 5, 83–93
Attitudes toward suicide in patients with HIV/AIDS. Omega, (1996). 34(1), 15–27
Suicide patterns and AIDS in San Francisco. IV International Conference on AIDS, Stockholm, Abstract 8597 (1988).
The relationship of pain and symptom management to patient requests for physician-assisted suicide. Journal of Pain and Symptom Management, (1991). 6(5), 289–297
AIDS and euthanasia. AIDS CARE, (1995). 7(supplement 2), S169–S173
Completed suicide with a fear of having contracted AIDS. A study of 28 cases. In JE Beskow, M Bellini, JG Sampaio Faria, ADJM Kerkhof (Eds.) HIV and AIDS related suicidal behavior: Report on a WHO consultation (pp. 69-76). Bologna: Monduzzi Editore (1991).
The San Francisco Medical Society euthanasia survey. Results and analysis. San Francisco Medicine, (1988). 61, 24–34
Psychological functioning in a cohort of gay men at risk for AIDS: A three-year descriptive study. The Journal of Nervous and Mental Disease, (1990). 178, 607–615
Death, society and human experiences. Boston: Allyn and Bacon (1998).
Premature death and self injurious behavior in old age. Geriatrics, (1971). 26, 70–81
AIDS and suicide in California. Journal of the American Medical Association, (1988). 260, 1881–
Patients who want to die: A survey. Canadian Family Physician, (1977). 23, 63–68
Euthanasia, assisted suicide and AIDS. AIDS CARE, (1995). 7 (Supplement 2), S163–S167
Depression in the elderly: Effect on patient attitudes toward life-sustaining therapy. Journal of the American Geriatric Society, (1992). 40, 983–988
Public attitudes towards cancer pain. Cancer, (1985). 56, 2337–2339
Risk of suicide among cancer patients. American Journal of Epidemiology, (1979). 109, 59–65
Increased risk of suicide in persons with AIDS. Journal of the American Medical Association, (1988a). 259, 1333–1337
AIDS is associated with an increased risk of suicide. American Psychiatric Association Annual Meeting, Montreal New Research Abstracts (1988b).
Les enjeux dans les débats sur l'euthanasie active: Croyances et réalités. Frontières, (1995). 8(1), 20–24
A dynamic developmental model of suicide. Human Development, (1996). 39, 181–194
The right to die and the right to live: Perspectives on euthanasia and assisted suicide. In A Leenaars, S Wenckstern, I Sakinofsky, RJ Dyck, MJ Kral, RC Bland (Eds.) Suicide in Canada (pp. 441-458). Toronto: University of Toronto Press (1998).
Suicide and AIDS: From research to prevention. Presentation at the 31st Annual Conference of the American Association of Suicidology, Washington DC (April 18, 1998).
AIDS patients compared with others seen in psychiatric consultation. General Hospital Psychiatry, (1990). 12, 50–55
Assessment and management of the AIDS patient with neuropsychiatric disturbances. Journal of Clinical Psychiatry, (1988). 49, 14–22
Suicidal ideation and HIV testing. Journal of the American Medical Association, (1990). 263, 679–682
Underscore urgency of HIV counselling: Several suicides follow positive tests. Clinical Psychiatry News, (1987 (October)).
Suicide of AIDS patients in Texas: A preliminary report. Texas Medicine, (1989). 85, 40–43
HIV and suicide in Hamburg. AIDS CARE, (1995). 7 (supplement 2), S129–S133)
The gay adolescent: Stressors, adaptations, and psychological interventions. Clinical Psychology Review, (1997). 17, 191–216
Psychiatric diagnosis and attempted suicide in HIV infected USAF personnel. IV International Conference on AIDS, Stockholm, Abstract 8595 (1988).
The relationship of pain and depression to suicidal ideation in cancer patients. American Society of Clinical Oncology, (1989). 8, 1215–
AIDS-related factors predicting of suicidal ideation of low and high intent among gay and bisexual men. Suicide and Life-Threatening Behavior, (1991). 21(4), 1991–
Euthanasia: Why people want to die earlier. Social Science and Medicine, (1994). 39(5), 647–654
Suicide and AIDS: Lessons from a case not audit in London. AIDS CARE, (1995). 7(2), S109–S116
Physician-assisted suicide and patients with HIV disease. New England Journal of Medicine, (1997). 336(6),
Dissociation between the wishes of terminally ill parents and decisions by their offspring. Journal of the American Geriatrics Society, (1993). 41, 599–604
HIV infection: Psychiatric findings in the Netherlands. British Journal of Psychiatry, (1989). 155, 814–817
Depression, competence, and the right to refuse lifesaving medical treatment. American Journal of Psychiatry, (1994). 151(7), 971–978
AIDS, euthanasia and grief. AIDS CARE, (1995). 7 (supplement 2), S175–S185
Psychiatric aspects of AIDS. In AM Freedman, BJ Saldock (Eds.) Comprehensive textbook of psychiatry. Baltimore: Williams & Wilkins (1987).