Assisted suicide and mental disorders

I was alarmed to read an article in JAMA Psychiatry that examined the practice of euthanasia for psychiatric patients in the Netherlands (i.e. Kim et al., 2016). The article is commented on in an editorial by Applebaum titled ‘Physician-assisted death for patients with mental disorders – reasons for concern’.

Applebaum states: ‘52% of the Dutch cases and 50% of the Belgian cases carried diagnoses of personality disorders, conditions often associated with strong reactivity to environmental and interpersonal stresses, raising questions about the stability of the expressed desires to die.’ He continues to argue: ‘For psychiatric patients, however, for whom a desire to die is often part of the disorder and whose response to additional treatment is less certain, the competence of their decision and the intractability of their suffering are much more difficult to assess.’

These concerning practices – raised by an American journal – are happening here in Europe. What concerns me is that there seems to be little awareness or knowledge in Britain that this is happening in our region. People with mental health problems are a vulnerable population. I believe that this issue is too morally complex for one country to determine alone. I believe that the international mental health community – both service users and professionals – need to raise more public awareness about this issue.

I strongly urge BPS members to read the JAMA Psychiatry articles so that they can form their own opinion on this very important matter.

Chris Ludlow CPsychol
London NW3

References
Appelbaum, P.S. (2016). Physician-assisted death for patients with mental disorders – reasons for concern. JAMA Psychiatry, 73(4), 325–326.
Kim, S.Y., De Vries, R.G. & Peteet, J.R. (2016). Euthanasia and assisted suicide of patients with psychiatric disorders in the Netherlands 2011 to 2014. JAMA Psychiatry, 73(4), 362–368.