[Euthanasia and assisted suicide in people with mental disorders]

Area of Science:

• Medical Ethics
• Psychiatry
• Legal Medicine

Background:

• Euthanasia and assisted suicide (ESA) are legally permitted for non-terminal illnesses in select European countries and Spain.
• The practice is expanding to include patients with mental disorders (TM) and dementia (D).

Purpose of the Study:

• To review studies on ESA in patients with TM and/or D.
• To assess the feasibility of meeting legal requirements for ESA in this population.
• To examine ethical and legal challenges associated with ESA for TM-D patients.

Main Methods:

• Literature review of existing studies on ESA in patients with mental disorders and/or dementia.
• Analysis of legal frameworks and ethical considerations.
• Exploration of potential compliance failures and fraud in ESA applications.

Main Results:

• Compliance with legal requirements for ESA is particularly challenging in patients with TM-D due to disease characteristics and legal security gaps.
• Potential for fraud exists, possibly unprosecuted due to societal complicity or medical cooperation.
• Critical ethical-deontological considerations arise regarding ESA approval for TM-D patients.

Conclusions:

• ESA for patients with TM-D presents significant ethical and practical difficulties.
• Palliative psychiatry is proposed as an alternative, focusing on improving quality of life and relieving suffering for patients and families.
• Further reflection on the errors and consequences of ESA in this vulnerable population is warranted.