In a scientific article published in the Journal of Death and Dying, the research group argues that there are issues that should be addressed under medically assisted death legislation, such as identifying people who can change their minds, defining a different waiting period for terminal and non-terminal illnesses, as well as realizing that personal conditions can enhance the desire to anticipate death.

Lacking studies on euthanasia and decision making, the study evaluated the existing literature on suicidal ideation, suicide attempt and suicide in different populations.

According to Miguel Ricou, professor of bioethics at FMUP and researcher at CINTESIS, the results suggest that “there is a strong possibility of reversal of the desire to die, so it is necessary to distinguish between individuals who will maintain their desire and benefit from the end of life and others who might change their minds.”

At this point, the researchers clearly identify the cases of terminally ill patients, who sometimes live in great distress, and where the decline is continuous, which hinders their ability to adapt.

"These are cases that can benefit from early death, if this is the will of the patient, and whose process can become futile if it is too late," said Miguel Ricou.

However, in the remaining cases, the authors of this study propose to consider other issues.

"Suicide studies show that in the first two years, most people who think or attempt suicide change their minds and stop wishing for death," said the researcher.

He therefore argues that "this information should be taken into account before deciding whether someone with a chronic illness or who has lost any function (such as walking or vision, for example) may ask to die."

“The process of adaptation can be very different from that which happens in terminal illnesses, being closer to what seems to happen in suicide. There may be even more room for an intervention that fosters the patient's adaptation to his new condition and reverses the death wish,” said Miguel Ricou.

Therefore, researchers advise that a “longer assessment period” be defined for early death requests made by non-terminally ill patients, as this “may encourage the patient's adaptation to their living conditions by reducing suffering and eventually reversing the desire to die.”

Other variables that interfere with the desire to die are depressive symptomatology, or “hopelessness,” loss of functionality, low levels of social support, and perceived loss of dignity.

According to Miguel Ricou, "In these cases too, time and psychological intervention can be helpful in misleading patients in whom there is room for a change of mind."

"It is not acceptable that in a process that involves the conscious decision making of a patient, psychological intervention is not considered in any bill," he said.

The study also refers to the association between some personality traits and suicide, such as impulsivity and assertiveness.

Researchers also report that in Portugal the suicide rate in 2010 was 10.3 per 100,000 people, a higher rate than other violent deaths, such as car accidents and work-related deaths.

"These numbers reveal the need to better examine and understand the desire to die and especially the events that trigger it," the researcher added.

Earlier work by the same research group released in July found that 60 percent of doctors favour legalizing euthanasia in Portugal. The same study indicated that the suffering manifested by the patient as a result of the disease is, for doctors, a more relevant criterion than respect for autonomy, even though the latter is a mandatory condition.