Il suicidio assistito per pazienti con depressione grave. Un’opzione inaccettabile che gli psichiatri devono combattere fermamente

The debate on assisted suicide for patients suffering from severe depression raises complex issues spanning clinical, ethical, scientific, medico-legal, and cultural domains. This position paper asserts that such an option is unacceptable in the context of depressive illness, even in its most severe and treatment-resistant forms. Depression is not an irreversible or terminal condition: there are multiple therapeutic options available, including spontaneous and late remissions, and suicidal ideation must be seen as a core symptom of the disorder, not as a rational choice. Scientifically, there are no reliable biomarkers to define the "incurability" of depression, and prognosis is often uncertain. Ethically, the principle of non-maleficence prohibits physicians from contributing to a patient's death, while the vulnerability of individuals with severe depression impairs their decision-making capacity. From a medico-legal standpoint, it is extremely difficult to assess competence in such contexts with any degree of certainty. Culturally and symbolically, psychiatry must reaffirm its healing mandate and resist dangerous shifts that could legitimize stigma or suicidal contagion. In conclusion, psychiatrists cannot and must not adopt the role of facilitators of death. Instead, they are called to provide care, instil hope, and protect patients, even in the most challenging clinical scenarios.