11 Feb Euthanasia and/or Physician Assisted Suicide in Psychiatric Disorders Legal in Belgium and The Netherlands
MedicalResearch.com Interview with:
Scott Y. H. Kim, MD, PhD
Department of Bioethics, National Institutes of Health
Bethesda, MD 20892
Medical Research: What is the background for this study?
Dr. Kim: Euthanasia and/or physician assisted suicide (EAS) of persons suffering from psychiatric disorders is increasingly practiced in some jurisdictions such as Belgium and the Netherlands but very little is known about the practice. There is an active debate over whether to legalize such a practice in Canada, after a Supreme Court ruling last year that struck down laws banning physician assisted death.
Medical Research: What are the main findings?
Dr. Kim: The main findings are that:
- Most patients who receive psychiatric euthanasia and/or physician assisted suicide are women, of diverse ages, with a variety of chronic psychiatric conditions accompanied by personality disorders, significant physical problems, and social isolation/loneliness, often in the context of refusals of treatment. A minority who are initially refused EAS ultimately receive euthanasia and/or physician assisted suicide through a mobile euthanasia clinic.
- Given that the patients have chronic, complicated histories requiring considerable physician judgment, extensive consultations are common. But independent psychiatric input does not always occur; disagreement among physicians occurred in one in four cases; and the euthanasia review committees generally defer to the judgments of the physicians performing euthanasia and/or physician assisted suicide.
Medical Research: What should clinicians and patients take away from your report?
Dr. Kim: In the US, the practice is illegal.
Medical Research: What recommendations do you have for future research as a result of this study?
Dr. Kim: Although there are important population based data on EAS practice in the Netherlands and Belgium, there is a paucity of studies like ours. Our study is the first study that gives details about the patients’ various psychiatric, medical, and social conditions; their histories (including treatment history, suicide attempts, treatment refusals); the physicians’ evaluation of the patients; and how the euthanasia review committees retrospectively reviewed the cases. For the first time, it provides a more fine-grained picture (than mere quantitative data on reporting rates, etc) of what is happening when patients suffering from psychiatric disorders are euthanized or given lethal doses of medications for ingestion under the Dutch system.
More studies like this one could be done by other researchers and that could help policymakers make evidence-based, rather than ideologically driven, decisions.
Scott Y. H. Kim, MD, PhD (2016). Euthanasia and/or Physician Assisted Suicide in Psychiatric Disorders Legal in Belgium and The Netherlands