Objectives
To identify patterns in
euthanasia requests and practices relating to psychiatric patients; to generate
recommendations for future research.
Design
Retrospective analysis
of data obtained through medical file review.
Setting
Outpatient psychiatric
clinical setting in the Dutch-speaking region of Belgium, between October 2007
and December 2011; follow-up at the end of December 2012.
Participants
100 consecutive
psychiatric patients requesting euthanasia based on psychological suffering
associated with psychiatric disorders (77 women, 23 men; mean age 47 years; age
range 21–80 years).
Main outcome measures
Patient sociodemographic
characteristics; diagnoses; decisions on euthanasia requests; circumstances of
euthanasia procedures; patient outcomes at follow-up.
Results
Most patients had been
referred for psychiatric counselling by their physician (n=55) or by LEIF (Life
End Information Forum) (n=36). 90 patients had >1 disorder; the most
frequent diagnoses were depression (n=58) and personality disorder (n=50). 38
patients required further testing and/or treatment, including 13 specifically
tested for autism spectrum disorder (ASD); 12 received an ASD diagnosis (all
Asperger syndrome). In total, 48 of the euthanasia requests were accepted and
35 were carried out. Of the 13 remaining patients whose requests were accepted,
8 postponed or cancelled the procedure, because simply having this option gave
them enough peace of mind to continue living. In December 2012, 43 patients had
died, including 35 by euthanasia; others died by suicide (6), palliative
sedation (1) and anorexia nervosa (1).
Conclusions
Depression and
personality disorders are the most common diagnoses in psychiatric patients
requesting euthanasia, with Asperger syndrome representing a neglected disease
burden. Further research is needed, especially prospective quantitative and
qualitative studies, to obtain a better understanding of patients with
psychiatric disorders who request euthanasia due to unbearable psychological
suffering.
Below: Frequency of age in 100 psychiatric patients who requested euthanasia, by gender
Full article at: http://goo.gl/6fSQex
By:
1University Hospital Brussels, Brussels,
Belgium
2MSc student at the Open University of the
Netherlands, Heerlen, The Netherlands
3Free University of Brussels, Brussels,
Belgium
4Department of Psychiatry, Ghent University
Hospital, Ghent, Belgium
5University of Antwerp, Institute
Born-Bunge, Wilrijk, Belgium
6University of Groningen, University
Medical Center Groningen, Groningen, The Netherlands
7Middelheim General Hospital, ZNA, Antwerp,
Belgium
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