The Contribution of Demoralization to End of Life Decisionmaking‪.‬

Some psychiatrists believe that "demoralization syndrome" is a diagnosable cognitive disorder characterized in its extreme form by morbid existential distress. If they are right, then it should be an important part of our thinking about end of life decisionmaking. A demoralized patient would be unable to think reliably about the remainder of her life, and therefore incompetent to decide to commit physician-assisted suicide. The pointlessness of a wretched existence, in which meaning and purpose are lost and despair is pervasive, can lead to a wish to die. This mental state may develop in association with the suffering of the chronically medically ill and of the dying.