[Euthanasia and assisted suicide for psychiatric disorder]

Area of Science:

• Medical Ethics
• Psychiatry
• Public Health Policy

Background:

• Assisted death legislation varies globally, with some countries permitting it for psychiatric reasons.
• The debate includes psychological pain as a criterion, adding complexity to end-of-life care discussions.

Purpose of the Study:

• To review literature on the characteristics of patients with psychiatric disorders requesting assisted death.
• To analyze trends and patient demographics in countries with legal assisted death for psychiatric conditions.

Main Methods:

• Narrative literature review.
• Inclusion of scientific manuscripts, reports, and legal documents from relevant countries.

Main Results:

• Incidence of assisted death for psychiatric reasons is low but rising, representing 1.1-4.5% of cases.
• Most frequent diagnoses include depressive and personality disorders.
• Patients requesting assisted death were more often women than men, differing from general suicide demographics.

Conclusions:

• Arguments for assisted death emphasize dignity and equality for psychiatric patients.
• Challenges include assessing psychological pain, cognitive impairments, and defining treatment refractoriness in psychiatry.
• Current medical knowledge and tools are insufficient for adequate assessment and support in these cases.