Cargando…
Euthanasia and physician-assisted suicide in patients suffering from psychiatric disorders: a cross-sectional study exploring the experiences of Dutch psychiatrists
BACKGROUND: The medical-ethical dilemmas related to euthanasia and physician-assisted suicide (EAS) in psychiatric patients are highly relevant in an international context. EAS in psychiatric patients appears to become more frequent in the Netherlands. However, little is known about the experiences...
Autores principales: | , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2019
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6381744/ https://www.ncbi.nlm.nih.gov/pubmed/30782146 http://dx.doi.org/10.1186/s12888-019-2053-3 |
_version_ | 1783396565386264576 |
---|---|
author | Evenblij, Kirsten Pasman, H. Roeline W. Pronk, Rosalie Onwuteaka-Philipsen, Bregje D. |
author_facet | Evenblij, Kirsten Pasman, H. Roeline W. Pronk, Rosalie Onwuteaka-Philipsen, Bregje D. |
author_sort | Evenblij, Kirsten |
collection | PubMed |
description | BACKGROUND: The medical-ethical dilemmas related to euthanasia and physician-assisted suicide (EAS) in psychiatric patients are highly relevant in an international context. EAS in psychiatric patients appears to become more frequent in the Netherlands. However, little is known about the experiences of psychiatrists with this practice. This study aims to estimate the incidence of EAS (requests) in psychiatric practice in The Netherlands and to describe the characteristics of psychiatric patients requesting EAS, the decision-making process and outcomes of these requests. METHODS: In the context of the third evaluation of the Dutch Euthanasia Act, a cross-sectional study was performed between May and September 2016. A questionnaire was sent to a random sample of 500 Dutch psychiatrists. Of the 425 eligible psychiatrists 49% responded. Frequencies of EAS and EAS requests were estimated. Detailed information was asked about the most recent case in which psychiatrists granted and/or refused an EAS request, if any. RESULTS: The total number of psychiatric patients explicitly requesting for EAS was estimated to be between 1100 and 1150 for all psychiatrists in a one year period from 2015 to 2016. An estimated 60 to 70 patients received EAS in this period. Nine psychiatrists described a case in which they granted an EAS request from a psychiatric patient. Five of these nine patients had a mood disorder. Three patients had somatic comorbidity. Main reasons to request EAS were ‘depressive feelings’ and ‘suffering without prospect of improvement’. Sixty-six psychiatrists described a case in which they refused an EAS request. 59% of these patients had a personality disorder and 19% had somatic comorbidity. Main reasons to request EAS were ‘depressive feelings’ and ‘desperate situations in several areas of life’. Most requests were refused because the due care criteria were not met. CONCLUSIONS: Although the incidence of EAS in psychiatric patients increased over the past two decades, this practice remains relatively rare. This is probably due to the complexity of assessing the due care criteria in case of psychiatric suffering. Training and support may enable psychiatrists to address this sensitive issue in their work better. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1186/s12888-019-2053-3) contains supplementary material, which is available to authorized users. |
format | Online Article Text |
id | pubmed-6381744 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-63817442019-03-01 Euthanasia and physician-assisted suicide in patients suffering from psychiatric disorders: a cross-sectional study exploring the experiences of Dutch psychiatrists Evenblij, Kirsten Pasman, H. Roeline W. Pronk, Rosalie Onwuteaka-Philipsen, Bregje D. BMC Psychiatry Research Article BACKGROUND: The medical-ethical dilemmas related to euthanasia and physician-assisted suicide (EAS) in psychiatric patients are highly relevant in an international context. EAS in psychiatric patients appears to become more frequent in the Netherlands. However, little is known about the experiences of psychiatrists with this practice. This study aims to estimate the incidence of EAS (requests) in psychiatric practice in The Netherlands and to describe the characteristics of psychiatric patients requesting EAS, the decision-making process and outcomes of these requests. METHODS: In the context of the third evaluation of the Dutch Euthanasia Act, a cross-sectional study was performed between May and September 2016. A questionnaire was sent to a random sample of 500 Dutch psychiatrists. Of the 425 eligible psychiatrists 49% responded. Frequencies of EAS and EAS requests were estimated. Detailed information was asked about the most recent case in which psychiatrists granted and/or refused an EAS request, if any. RESULTS: The total number of psychiatric patients explicitly requesting for EAS was estimated to be between 1100 and 1150 for all psychiatrists in a one year period from 2015 to 2016. An estimated 60 to 70 patients received EAS in this period. Nine psychiatrists described a case in which they granted an EAS request from a psychiatric patient. Five of these nine patients had a mood disorder. Three patients had somatic comorbidity. Main reasons to request EAS were ‘depressive feelings’ and ‘suffering without prospect of improvement’. Sixty-six psychiatrists described a case in which they refused an EAS request. 59% of these patients had a personality disorder and 19% had somatic comorbidity. Main reasons to request EAS were ‘depressive feelings’ and ‘desperate situations in several areas of life’. Most requests were refused because the due care criteria were not met. CONCLUSIONS: Although the incidence of EAS in psychiatric patients increased over the past two decades, this practice remains relatively rare. This is probably due to the complexity of assessing the due care criteria in case of psychiatric suffering. Training and support may enable psychiatrists to address this sensitive issue in their work better. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1186/s12888-019-2053-3) contains supplementary material, which is available to authorized users. BioMed Central 2019-02-19 /pmc/articles/PMC6381744/ /pubmed/30782146 http://dx.doi.org/10.1186/s12888-019-2053-3 Text en © The Author(s). 2019 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. |
spellingShingle | Research Article Evenblij, Kirsten Pasman, H. Roeline W. Pronk, Rosalie Onwuteaka-Philipsen, Bregje D. Euthanasia and physician-assisted suicide in patients suffering from psychiatric disorders: a cross-sectional study exploring the experiences of Dutch psychiatrists |
title | Euthanasia and physician-assisted suicide in patients suffering from psychiatric disorders: a cross-sectional study exploring the experiences of Dutch psychiatrists |
title_full | Euthanasia and physician-assisted suicide in patients suffering from psychiatric disorders: a cross-sectional study exploring the experiences of Dutch psychiatrists |
title_fullStr | Euthanasia and physician-assisted suicide in patients suffering from psychiatric disorders: a cross-sectional study exploring the experiences of Dutch psychiatrists |
title_full_unstemmed | Euthanasia and physician-assisted suicide in patients suffering from psychiatric disorders: a cross-sectional study exploring the experiences of Dutch psychiatrists |
title_short | Euthanasia and physician-assisted suicide in patients suffering from psychiatric disorders: a cross-sectional study exploring the experiences of Dutch psychiatrists |
title_sort | euthanasia and physician-assisted suicide in patients suffering from psychiatric disorders: a cross-sectional study exploring the experiences of dutch psychiatrists |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6381744/ https://www.ncbi.nlm.nih.gov/pubmed/30782146 http://dx.doi.org/10.1186/s12888-019-2053-3 |
work_keys_str_mv | AT evenblijkirsten euthanasiaandphysicianassistedsuicideinpatientssufferingfrompsychiatricdisordersacrosssectionalstudyexploringtheexperiencesofdutchpsychiatrists AT pasmanhroelinew euthanasiaandphysicianassistedsuicideinpatientssufferingfrompsychiatricdisordersacrosssectionalstudyexploringtheexperiencesofdutchpsychiatrists AT pronkrosalie euthanasiaandphysicianassistedsuicideinpatientssufferingfrompsychiatricdisordersacrosssectionalstudyexploringtheexperiencesofdutchpsychiatrists AT onwuteakaphilipsenbregjed euthanasiaandphysicianassistedsuicideinpatientssufferingfrompsychiatricdisordersacrosssectionalstudyexploringtheexperiencesofdutchpsychiatrists |