[Euthanasia requests by patients with a borderline personality organisation]

Psychodynamic processes may play a role in the evaluation of a euthanasia request from a patient with a borderline personality organization. From the perspective of two-person psychology it is understandable that, unbearable and irremediable suffering (important conditions for euthanasia) are not only characteristics of the patients’ suffering, but also acquire meaning in the interaction with the psychiatrist. It is important that the psychiatrist recognizes immature defence mechanisms and forms of non-mentalizing. Understanding how symptoms of personality pathology may become manifest in the therapeutic relationship can be helpful in the dialogue with the patient about the potential impact of personality dynamics on the request for euthanasia and treatment options.