Countertransference and Assisted Suicide
![handle is hein.journals/ilmed16 and id is 251 raw text is: Countertransference and
Assisted Suicide*
Francis T. Varghese, M.B.B.S., ER.A.N.Z.C.P., and
Brian Kelly, B.Med., Ph.D., ER.A.N.Z.C.P.
The role of a doctor in assisting a patient to commit suicide or in taking some
other part in the termination of life is complex in the breadth of social, ethical, and
psychological implications. There is a tendency to reduce this complexity to dis-
cussions about individual rights and legal issues. The underlying dilemma was
highlighted by Annas in his comment that [d] iscussions of assisted suicide ... are
all symptoms of the problem modem medicine has with dying rather than the
solution.' In community, legal, and medical debate on these issues, little attention
has been paid to the role of the doctor-patient relationship in end-of-life decisions.
Indeed, the impact and meaning of the request for assisted suicide with reference to
transference and countertransference in the doctor-patient relationship have not
been addressed. This lack of attention to these issues emphasizes the need for
research to help us understand the motivation for patient requests for euthanasia
and the context of these requests within the doctor-patient relationship. However,
there has been relatively little research focusing on dying patients and their doctors
regarding such critical issues.2 Much more attention has been paid to documenting
the attitudes of doctors and the community to euthanasia and end-of-life decisions,
as if the issue could be laid to rest by results of opinion polls.3
* This article is reprinted with permission from chapter five of COUNTERTRANSFERENCE ISSUES IN PSY-
CHIATRIC TREATMENT 85 (Glen 0. Gabbard, ed. 1999) (Review of Psychiatry Series, Vol. 18, No. 1, John
M. Oldham & Michelle B. Riba, series eds.), published by the American Psychiatric Press, Inc., copy-
right © 1999. Permission requests should be addressed to the Permissions Manager - Books, Ameri-
can Psychiatric Press, Inc., 1400 K Street, N.W, Washington, DC 20005.
1 G.J. Annas, Physician-Assisted Suicide: Michigan's Temporary Solution, 328 NEW ENG. J. MED. 1573,
1573 (1993).
2 See K.T. Severson, Dying Cancer Patients: Choices at the End of Life, 14J. PAIN SYMPTOM MANAGEMENT
94 (1997).
3 See H. Kuhse et al., End-of-Life Decisions in Australian Medical Practice, 166 MED. J. AUSTRALIA 191
(1997).](ViewImageLocal?handle=hein.journals/ilmed16&div=24&collection=&method=preview&ext=.png&size=3)
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