It's a case and commentary article; a specific case is presented and then the ethics and limitations of the tools/methods and the physician's role are examined. In this case, it is the limitations of hope as a therapeutic tool for a specific (fictional) patient and the possibility that, in some cases, depression can be considered a terminal illness, that the patients expressed wish to die by suicide is a deliberative decision by an autonomous patient rather than an impulsive decision, and the continued use of hope as a therapeutic tool might be unhelpful and possibly unethical under the circumstances.
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"Abstract
This commentary explores the utility of hope as a therapeutic tool for intervention in the case of a patient with a mental illness that is refractory to treatment over time, who expresses her intention to commit suicide. It begins with a short discussion differentiating a deliberative consideration of suicide from an impulsive act. Then the commentary defines hope, how it might be used as a therapeutic tool, and which limitations a clinician might confront in such a case. This commentary also considers the role of a physician in orientation not only to the patient but also to her own thoughts, feelings, and emotions regarding a patient's expressed desire to end her life."
From the conclusion:
"So, an important lesson for physicians and physicians-in-training from cases like this one has to do with understanding that mental illness can be a terminal illness and that the concept of hope has therapeutic limitations."
"In this case, the utilization of hope as an intervening tool in this patient's suicide plan might not be justifiable from an ethical perspective."
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I didn't write it, nor am I taking any kind of position on it, I'm just sharing it with the community since some may find it interesting given the subject matter.
