Debating Euthanasia and Physician-Assisted Death in People with Psychiatric Disorders

Area of Science:

• Medical Ethics
• Psychiatry
• End-of-Life Care

Background:

• Medical assistance in dying (MAiD), including euthanasia and physician-assisted suicide, is a significant global debate.
• The inclusion of individuals with psychiatric disorders, particularly those with severe and treatment-resistant conditions, complicates this discussion.

Purpose of the Study:

• To review the existing literature on MAiD for patients with psychiatric disorders who are not in a terminal physical condition (non-terminal MAiD-NT).
• To explore the complexities and ethical considerations surrounding MAiD for psychiatric conditions.

Main Methods:

• Systematic literature review utilizing multiple databases.
• Inclusion of relevant studies published as full journal articles focusing on MAiD for psychiatric disorders.

Main Results:

• A small percentage of individuals with psychiatric disorders opt for MAiD-NT compared to those with terminal somatic diseases.
• Legalization of MAiD-NT for psychiatric disorders is limited to a few countries, highlighting ongoing international debate.
• Key challenges include objectively defining irremediability of mental disorders and balancing suicide prevention with assisted suicide.

Conclusions:

• The application of MAiD-NT in psychiatric patients requires further exploration to ensure end-of-life rights do not conflict with recovery-oriented care.
• Critical ethical points include assessing irremediability, balancing suicide prevention, and protecting vulnerable populations.