Assisted Suicide and Euthanasia of Patients with Mental Disorders: An Emerging Ethical Crisis

Grand Rounds for Department of Psychiatry, Rocky Vista University, Colorado, Feb 4, 2021
In several European countries physician-assisted suicide and euthanasia by lethal injection are being made available to psychiatric patients with non-terminal mental illnesses, commonly administered by their own treating psychiatrists giving the injection. Canada now offers euthanasia by injection for patients who are not strictly terminally ill and is on the verge of making it available to those with psychiatric disorders only. This raises profound ethical questions, for psychiatrists in particular, who have a core ethos and skill set to prevent suicide, help patients cope with suffering, find alternative paths to a better future, even make meaning of suffering. Allowing psychiatrists to help their patients suicide inverts the fundamental ethical framework and very definition of what it means to be a psychiatrist, who typically prevent rather than provide suicide.. This lecture examines the history of developments in Europe, Canada, and the U.S. regarding physician-assisted suicide and euthanasia of non-terminal psychiatric patients. Data from Belgium and Netherlands are reviewed. The positions of medical and psychiatric organizations around the world are shown, especially the new ethical position against such practices by the American Psychiatric Association. Fundamental ethical arguments in favor of psychiatric euthanasia are contrasted with those against. Clinical, social, and professional consequences are reviewed, including some specific cases, relevant data, and evidence for a “slippery slope’ of these policies and practices. Finally, the way these activities challenge the fundamental identity of the psychiatric profession will be discussed, and how this is an unanticipated consequence of pursuing parity for the mentally ill
Mark Komrad MD Website: : www.KomradMD.com
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