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Published on: September 11, 2021
[Assisted suicide: assessment and evaluation of the ability to make a freely responsible decision]
Norbert Nedopil1, Peter Brieger2
1Abteilung für Forensische Psychiatrie, Klinik und Poliklinik für Psychiatrie und Psychotherapie, LMU Klinikum, Universität München, Nussbaumstr. 7, 80336, München, Deutschland. Norbert.Nedopil@med.uni-muenchen.de.
Abstract:
This article addresses the question of how the capacity to make a freely responsible decision in assisted suicide can be assessed and evaluated. Based on medical ethics and legal principles as well as international comparisons, it is argued that the decision to commit suicide places special demands on autonomy, decision-making and inner strength. The concept of "free responsibility" is analysed in contrast to legal capacity and capacity to consent and is located in its proximity to these concepts.An operationalisation is proposed that includes understanding, autonomous evaluation, sustainable decision-making and the ability to act independently. In addition, practical challenges for assessment are discussed, particularly with regard to the role of psychiatrists, the separation of functions and ensuring open-ended procedures.The article advocates a narrow definition of free responsibility and a standardised assessment practice based on established and proven concepts of assessment in forensic psychiatry in order to guarantee both the protection of vulnerable persons and the fundamental right to self-determination.
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