When Patients and Providers Feel Helpless: A Commentary on “Palliative Care for Refractory Depressive Symptoms in a Female Veteran Geriatric Patient”

AbstractWhether providers should ever help patients die when they profoundly suffer from seemingly irreversible psychiatric illness is globally controversial. For example, in 2016, the American Psychiatric Association held that psychiatrists should never help bring about such patients' deaths, whereas in the Netherlands this intervention has been permitted for 30 years, and the number has increased from 2 in 2011 to 83 in 2017. This commentary asks when, if ever, providers should give up on seeking to treat these patients. Providers who have been exceptionally successful at reaching and helping these patients and some of the approaches they used are presented. These include particularly their helping these patients see meaning in their lives, using humor, and understanding them or at least trying to. I propose that establishing a felt connection may always remain possible and that this end may be a more important goal than any other.