As a physician who has seen several people misdiagnosed as terminally ill, I am not impressed by some of my colleagues' prognostic skills. In my experience, the mentally competent group is a small portion. More often, those wishing to die have treatable problems that alter their thinking. Up to 50 percent of elderly patients in hospitals and 45 to 85 percent of seniors in nursing homes are malnourished. These statistics are significant, because even slight malnutrition may cause decreased concentration, confusion and depression, leading to suicidal thoughts.
Drugs are well-known precipitants of similar symptoms.
Finally, psychiatric diseases, particularly major depression, impair one's ability to think clearly or reasonably consider options. Effective treatment is available for each of these conditions. The influence of others cannot be overestimated. In both this country and the Netherlands, many parties have pressured vulnerable persons through arguments about the expense of staying alive, the depletion of families' revenue and resources, and the fear of pain or losing control. An ill person who is frightened, lonely or confused can fall prey to friendly-sounding manipulators.