Citation

Kelly BD, McLoughlin DM. Psychiatry 2006; 5(8): 289-291.

Copyright

(Copyright © 2006, Medicine Publishing Company Ltd.)

DOI

10.1053/j.mppsy.2006.05.007

PMID

unavailable

Abstract

Physician-assisted suicide (PAS) is permitted in only a few jurisdictions (e.g. Oregon, USA; The Netherlands). In The Netherlands, PAS can be provided for psychiatric illness alone, even though the underlying biological causes of most psychiatric illnesses are unknown and the prognoses tend to be uncertain. There is an important role for psychiatrists and mental health teams in assessing and treating individuals with terminal physical illness who also develop psychiatric illness. There are, however, no agreed criteria to guide mandatory psychiatric assessment of the competence of terminally ill individuals who request PAS. The majority of psychiatrists feel they would not be able to make such a decision after a single assessment and, moreover, there is evidence that psychiatrists' moral views may affect their judgements. There are important roles for psychiatrists in terminal care settings but there is insufficient biological understanding of most common psychiatric illnesses to describe them as 'terminal', with the exception of certain neurodegenerative disorders (e.g. advanced Alzheimer's disease). While there is an overwhelming case in favour of psychiatric liaison with terminal care providers, the introduction of mandatory psychiatric assessment for all individuals requesting PAS would be ill-advised. © 2006 Elsevier Ltd. All rights reserved.

Language: en

Keywords

United States; human; suicide; psychiatry; assisted suicide; Netherlands; medical ethics; ethics; review; psychiatrist; psychologic assessment; medical liability; medicolegal aspect; priority journal; terminal disease; terminal care; active euthanasia; mental patient; criminal law; Switzerland; physician attitude; competence; legal liability; criminal justice; patient decision making; non-fatal self-harm; mental competency; PAS; physician-assisted suicide