We found Dr Eddy's essay, “A Conversation With My Mother,”1 both thought provoking and disturbing— thought provoking in that the essay presents, in a personal and dramatic manner, the numerous medical, emotional, ethical, legal, and philosophical issues surrounding euthanasia, patient autonomy, and physician-assisted suicide. These issues are far too complex for the scope of this letter; however, we wish to address the more disturbing point raised by the essay: suicidal intention in a chronically ill elderly patient with a known history of depression. Eddy reports that his mother, prior to the last 6 months of her life, was on Elavil (amitriptyline) for the successful treatment of depression. Following her cholecystectomy, complications occurred and “her antidepressants got out of balance.” The antidepressants were stabilized and “working again” following her second surgery, “but she was very unhappy. She knew. it was very unlikely she would ever be able to. © 1995, American Medical Association. All rights reserved.