By Ellen Arkfeld

Assisted suicide for psychiatric patients has been legal in the Netherlands since 1993, a country with some of the longest standing euthanasia practices. The main argument for euthanasia in the Netherlands is the autonomy of the patient. Whether psychiatric patients are able to objectively determine that their suffering is irreversible is coming under question in a recent study on assisted suicide in patients with mental disorders. Click here to watch a video.

The study found that in more than half of approved cases, patients could have been helped by treatment that they declined.  The most common diagnosis was depression, and this was frequently accompanied by diagnoses of other personality and mental disorders.  The study found that many patients often said that loneliness motivated their choice. Click here to learn more.

Further, patients often got assistance to die from doctors they didn’t know, and many used a “mobile end-of-life clinic”, which consists of a doctor and a nurse and is funded by a euthanasia advocacy organization.  Physicians and bioethicists are critical of the fact that doctors other than psychiatrists are making these decisions.

This study presents a conflict between the desire to maintain patient autonomy and the nature of psychiatric disorders.  On one hand, the suffering that patients endure in mental health cases should be treated as seriously as the suffering of physical health cases, and the autonomy of psychiatric patients should be respected just like the autonomy of patients with physical illnesses. However, as this study shows, a common symptom of mental illnesses like depression is the feeling that things will not improve.  Some worry that planning the death of psychiatric patients indicates a failure in treatment.

In the United States, assisted suicide is only legal in five states for adults with terminal illnesses, and is illegal for patients with mental health disorders.

Assisted suicide for patients with mental disorders is legal in the Netherlands, Belgium, and Switzerland, who have some of the most liberal assisted suicide laws in the world.   Euthanasia appears to be on the rise: in Belgium, there were 742 deaths from euthanasia between 2004 and 2005, but 2,086 between 2010 and 2011.

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