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The decision to die is a matter of values, not mental illness.

When conversations get difficult, or patients don’t do as they’re told, all too often the medical doctors turn to “psych consults.” A friend who’s married to a psychiatrist told me the hospital now tells “mental health professionals” to find patients incompetent when their decisions go against the hospital’s bottom line.

Psychiatrists can assess physiological components of mental illness; psychologists and some psychiatrists can help people change their thinking and behavior to become happier and enjoy smoother lives.

But what if your only option is living in “assisted care” with minimum-wage uncaring attendants, where you can be tied to a wheel chair in diapers and placed in front of a television for hours at a time, with tasteless food and frequent needle pricks for tests that don’t affect your longevity or well-being?

That’s the common nursing home experience and it doesn’t take a psychologist to see that a wish to die is completely rational.

A professional who diagnoses depression in this circumstance should be tied to a chair in front of a television set tuned to soap operas, wearing diapers, for at least 4 hours. Don’t tell him when you’ll be back. If he complains, say patronizingly, “Oh, are we feeling upset today?” and tell him he can’t have dessert after lunch. Throw in a few needle sticks and see how he feels at the end of the day.