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Externalist argument against medical assistance in dying for psychiatric illness

Medical assistance in dying, which includes voluntary euthanasia and assisted suicide, is legally permissible in a number of jurisdictions, including the Netherlands, Belgium, Switzerland and Canada. Although medical assistance in dying is most commonly provided for suffering associated with termina...

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Autor principal: Maung, Hane Htut
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BMJ Publishing Group 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10423508/
https://www.ncbi.nlm.nih.gov/pubmed/36175124
http://dx.doi.org/10.1136/jme-2022-108431
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author Maung, Hane Htut
author_facet Maung, Hane Htut
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description Medical assistance in dying, which includes voluntary euthanasia and assisted suicide, is legally permissible in a number of jurisdictions, including the Netherlands, Belgium, Switzerland and Canada. Although medical assistance in dying is most commonly provided for suffering associated with terminal somatic illness, some jurisdictions have also offered it for severe and irremediable psychiatric illness. Meanwhile, recent work in the philosophy of psychiatry has led to a renewed understanding of psychiatric illness that emphasises the role of the relation between the person and the external environment in the constitution of mental disorder. In this paper, I argue that this externalist approach to mental disorder highlights an ethical challenge to the practice of medical assistance in dying for psychiatric illness. At the level of the clinical assessment, externalism draws attention to potential social and environmental interventions that might have otherwise been overlooked by the standard approach to mental disorder, which may confound the judgement that there is no further reasonable alternative that could alleviate the person’s suffering. At the level of the wider society, externalism underscores how social prejudices and structural barriers that contribute to psychiatric illness constrain the affordances available to people and result in them seeking medical assistance in dying when they otherwise might not have had under better social conditions.
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spelling pubmed-104235082023-08-14 Externalist argument against medical assistance in dying for psychiatric illness Maung, Hane Htut J Med Ethics Original Research Medical assistance in dying, which includes voluntary euthanasia and assisted suicide, is legally permissible in a number of jurisdictions, including the Netherlands, Belgium, Switzerland and Canada. Although medical assistance in dying is most commonly provided for suffering associated with terminal somatic illness, some jurisdictions have also offered it for severe and irremediable psychiatric illness. Meanwhile, recent work in the philosophy of psychiatry has led to a renewed understanding of psychiatric illness that emphasises the role of the relation between the person and the external environment in the constitution of mental disorder. In this paper, I argue that this externalist approach to mental disorder highlights an ethical challenge to the practice of medical assistance in dying for psychiatric illness. At the level of the clinical assessment, externalism draws attention to potential social and environmental interventions that might have otherwise been overlooked by the standard approach to mental disorder, which may confound the judgement that there is no further reasonable alternative that could alleviate the person’s suffering. At the level of the wider society, externalism underscores how social prejudices and structural barriers that contribute to psychiatric illness constrain the affordances available to people and result in them seeking medical assistance in dying when they otherwise might not have had under better social conditions. BMJ Publishing Group 2023-08 2022-09-29 /pmc/articles/PMC10423508/ /pubmed/36175124 http://dx.doi.org/10.1136/jme-2022-108431 Text en © Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY. Published by BMJ. https://creativecommons.org/licenses/by/4.0/This is an open access article distributed in accordance with the Creative Commons Attribution 4.0 Unported (CC BY 4.0) license, which permits others to copy, redistribute, remix, transform and build upon this work for any purpose, provided the original work is properly cited, a link to the licence is given, and indication of whether changes were made. See: https://creativecommons.org/licenses/by/4.0/.
spellingShingle Original Research
Maung, Hane Htut
Externalist argument against medical assistance in dying for psychiatric illness
title Externalist argument against medical assistance in dying for psychiatric illness
title_full Externalist argument against medical assistance in dying for psychiatric illness
title_fullStr Externalist argument against medical assistance in dying for psychiatric illness
title_full_unstemmed Externalist argument against medical assistance in dying for psychiatric illness
title_short Externalist argument against medical assistance in dying for psychiatric illness
title_sort externalist argument against medical assistance in dying for psychiatric illness
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10423508/
https://www.ncbi.nlm.nih.gov/pubmed/36175124
http://dx.doi.org/10.1136/jme-2022-108431
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