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Anne-Laure Serra, Friedrich Stiefel, Céline Bourquin

    Geriatrie Et Psychologie Neuropsychiatrie Du Vieillissement
    |June 2, 2022
    PubMed
    Summary
    This summary is machine-generated.

    Psychiatrists acting as gatekeepers for assisted suicide requests face challenges in addressing patients' underlying attachment issues and emotional distress. This role impacts therapeutic interventions, highlighting the need for careful consideration of the psychiatrist's position.

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    Area of Science:

    • Psychiatry
    • Psychology
    • Medical Ethics

    Background:

    • In Switzerland, psychiatrists serve as gatekeepers for assisted suicide requests.
    • Their role involves assessing patient discernment and potential psychiatric disorders impacting capacity.

    Purpose of the Study:

    • To explore the motives behind assisted suicide requests in somatic patients.
    • To examine the challenges psychiatrists face in this gatekeeper role.

    Main Methods:

    • Retrospective analysis of psychiatric reports for 18 patients (65+ years) requesting assisted suicide.
    • Application of attachment theory and psychodynamic concepts (Ideal ego, Ego ideal, Superego).

    Main Results:

    • Identified manifest and latent motives for assisted suicide requests.

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  • Found indications of secure/insecure attachment, shame, abandonment, and guilt.
  • The gatekeeper role limits therapeutic engagement with these underlying issues.

    • Conclusions:

    • The psychiatrist's gatekeeper role in assisted suicide is ethically and clinically challenging.
    • Balancing the gatekeeper function with liaison psychiatry requires careful consideration.