Practitioners' attitudes and approaches to assessing comorbid depression among patients seeking assisted dying in New Zealand

Depressive disorders are prevalent among the terminally ill and often impact decision-making capacity. However, routine screening for depression is not currently included in assisted dying assessments. This qualitative study aimed to explore the attitudes and approaches of ten New Zealand assisted dying practitioners in assessing comorbid depression among patients seeking assisted dying. Four main themes emerged: (i) depression was viewed as a minor concern in patients seeking assisted dying, (ii) practitioners used informal approaches to assess depression, (iii) there was overlap in symptoms of terminal illness and depression, and (iv) there was opposition to introducing new mandatory processes to assess depression. This study highlights a generally informal, non-systematised approach to depression screening as part of the assisted dying assessment process. Additions to the process, including routine depression screening will require input from assisted dying stakeholders due to concern about barriers or delays for patients seeking this.