Euthanasia for mental illness

Euthanasia for mental illness involves a physician intentionally ending the life of a patient who has requested euthanasia due to a psychiatric condition. The practice is legal in Belgium,[1] the Netherlands,[2] Luxembourg,[3] Spain[4] and Colombia.[5] In Canada, legislation authorizing the procedure was passed, but has since been repeatedly postponed.[6]

The practice is considered controversial as unlike with other types of euthanasia, a patient euthanized for mental illness alone is usually not terminally ill, and may have their decisional capacity impeded by their condition.[7][8][9] It is also considered more difficult with psychological conditions to determine an objective prognosis, or whether a disorder is irremediable.[10][11]

By country

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Belgium

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In Belgium, euthanasia for mental illness is legal if the patient is mentally competent to make the decision; the patient requests euthanasia on two separate occasions in writing; the patient is suffering from an incurable disease or mental illness, and all treatment options have been exhausted; and the patient is experiencing "unbearable suffering" from the illness, either physically or psychologically.[12] Three doctors must agree to grant euthanasia in psychiatric cases.[13][14] Euthanasia for mental suffering is not available for children.[15]

As of 2017, approximately 40 patients per year received euthanasia due to mental illness, out of approximately 2,000 total yearly euthanasia deaths.[15]

In 2020, a Belgium court acquitted three doctors who had euthanized Tine Nys, a physically healthy 38-year-old woman with autism, of manslaughter charges.[16] Nys' sister Sophie Nys had filed a lawsuit alleging that the doctors did not properly attempt to treat her condition, and that Nys had not been incurably ill as the law required.[16]

Netherlands

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Euthanasia for mental illness has been legal since 2002 in the Netherlands provided the patient has "unbearable suffering with no prospect of improvement" and has requested to die in a way that is "voluntary, well considered and with full conviction", among other criteria.[17][18] In 2020, the Supreme Court of the Netherlands ruled that physicians could euthanize patients with dementia if they had expressed a wish to die before the onset of their condition.[19]

The 2016 euthanasia of Eelco de Gooijer, a 38-year-old man from Tilburg who had depression and autism, was one of the first high-profile euthanasia cases involving a young person with a neurodevelopmental condition and mental illness.[18][20]

In 2023, 138 people in the Netherlands received euthanasia due to psychiatric conditions, a 20% increase from 2022.[21] The first minor euthanized for a psychiatric condition (who was between 16 and 18-years-old) was in 2023.[21]

References

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  1. ^ De Hert, Marc; Loos, Sien; Van Assche, Kristof (2023). "The Belgian euthanasia law under scrutiny of the highest courts". The Lancet Regional Health - Europe. 24. Elsevier BV: 100549. doi:10.1016/j.lanepe.2022.100549. hdl:10067/1925430151162165141. ISSN 2666-7762.
  2. ^ van Veen, SMP; Widdershoven, GAM; Beekman, ATF; Evans, N. (2022-06-20). "Physician Assisted Death for Psychiatric Suffering: Experiences in the Netherlands". Frontiers in Psychiatry. 13. Frontiers Media SA. doi:10.3389/fpsyt.2022.895387. ISSN 1664-0640. PMC 9251055. PMID 35795029.
  3. ^ "Information on requesting euthanasia or assisted suicide". Guichet.lu. 2023-12-08. Retrieved 2024-04-21.
  4. ^ Ramos-Pozón, Sergio; Terribas-Sala, Núria; Falcó-Pegueroles, Anna; Román-Maestre, Begoña (2023). "Persons with mental disorders and assisted dying practices in Spain: An overview". International Journal of Law and Psychiatry. 87. Elsevier BV. doi:10.1016/j.ijlp.2023.101871. hdl:2445/195880. ISSN 0160-2527. PMID 36871498.
  5. ^ Kuntz, Leah (2022-01-10). "First Colombian With Nonterminal Illness Legally Dies via Euthanasia". Psychiatric Times. Retrieved 2024-04-21.
  6. ^ McCulloch, Craig (2024-02-09). "Canada Postpones Plan to Allow Euthanasia for Mentally Ill". Voice of America. Retrieved 2024-04-21.
  7. ^ Yasgur, Batya Swift (2023-08-03). "Clinicians Talking: Euthanasia for SMI -- Right or Wrong?". Medscape. Retrieved 2024-04-21.
  8. ^ Olié, Emilie; Courtet, Philippe (2016-08-09). "The Controversial Issue of Euthanasia in Patients With Psychiatric Illness". JAMA. 316 (6). American Medical Association (AMA): 656–657. doi:10.1001/jama.2016.9883. ISSN 0098-7484. PMID 27532920.
  9. ^ Lane, Charles (2016-10-19). "Europe's morality crisis: Euthanizing the mentally ill". Washington Post. Archived from the original on 2016-12-02. Retrieved 2024-04-21.
  10. ^ Nicolini, Marie E.; Jardas, EJ; Zarate, Carlos A.; Gastmans, Chris; Kim, Scott Y. H. (2022-10-28). "Irremediability in psychiatric euthanasia: examining the objective standard". Psychological Medicine. 53 (12). Cambridge University Press (CUP): 5729–5747. doi:10.1017/s0033291722002951. ISSN 0033-2917. PMC 10482705. PMID 36305567.
  11. ^ Grassi, Luigi; Folesani, Federica; Marella, Marco; Tiberto, Elisa; Riba, Michelle B.; Bortolotti, Lisa; Toffanin, Tommaso; Palagini, Laura; Belvederi Murri, Martino; Biancosino, Bruno; Ferrara, Maria; Caruso, Rosangela (2022). "Debating Euthanasia and Physician-Assisted Death in People with Psychiatric Disorders". Current Psychiatry Reports. 24 (6). Springer Science and Business Media LLC: 325–335. doi:10.1007/s11920-022-01339-y. hdl:11392/2493393. ISSN 1523-3812. PMC 9203391. PMID 35678920.
  12. ^ "Dying with dignity: The story of euthanasia in Belgium". The Bulletin. 2021-01-02. Retrieved 2024-04-21.
  13. ^ "it may have saved my life'". Sky News. 2020-08-24. Retrieved 2024-04-21.
  14. ^ Aviv, Rachel (2015-06-15). "Who Has the Right to Die?". The New Yorker. Retrieved 2024-04-21.
  15. ^ a b "'What could help me to die?' Doctors clash over euthanasia". STAT. 2017-10-26. Retrieved 2024-04-21.
  16. ^ a b Peltier, Elian (2020-01-31). "Belgium Acquits Three Doctors in Landmark Euthanasia Case". The New York Times. Retrieved 2024-04-21.
  17. ^ "'Dying With Dignity': Dutch Mark 20 Years of Euthanasia". Voice of America. 2022-04-01. Retrieved 2024-04-21.
  18. ^ a b "Death on Demand: Has Euthanasia Gone Too Far?". Pulitzer Center. 2019-01-18. Retrieved 2024-04-21.
  19. ^ "Dutch court approves euthanasia in cases of advanced dementia". the Guardian. 2020-04-21. Retrieved 2024-04-21.
  20. ^ van Mersbergen, Chris; van de Zande, Theo (2016-10-28). "Eelco (38) uit Tilburg is psychisch lijden moe en kiest voor euthanasie (video)". bd.nl (in Dutch). Retrieved 2024-06-16.
  21. ^ a b Ferrer, Isabel (2024-04-19). "Debate ignites in the Netherlands over rise in euthanasia for mental disorders". EL PAÍS English. Retrieved 2024-04-21.
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