TY - JOUR
T1 - Do Doctors Differentiate Between Suicide and Physician-Assisted Death? A Qualitative Study into the Views of Psychiatrists and General Practitioners
AU - Pronk, Rosalie
AU - Willems, Dick L.
AU - van de Vathorst, Suzanne
N1 - Funding Information: This study was funded by the Dutch Right to Die Society (NVVE). However, the NVVE had no part in the design, data collection, interpretation or reporting of this work. Acknowledgements Publisher Copyright: © 2020, The Author(s).
PY - 2021/6
Y1 - 2021/6
N2 - Physician-assisted death for patients suffering from psychiatric disorders is allowed in the Netherlands under certain circumstances. One of the central problems that arise with regard to this practice is the question of whether it is possible to distinguish between suicidality and a request for physician-assisted death. We set up this study to gain insight into how psychiatrists and general practitioners distinguish between suicidality and physician-assisted death. The data for this study were collected through qualitative interviews with 20 general practitioners and 17 psychiatrists in the Netherlands. From the interviews, we conclude that physicians distinguish three types of death wishes among patients suffering from psychiatric disorders: ‘impulsive suicidality,’ ‘chronic suicidality,’ and ‘rational death wishes.’ To discern between them they evaluate whether the death wish is seen as part of the psychopathology, whether it is consistent over time, and whether they consider it treatable. Some considered physician-assisted death an alternative to a ‘rational suicide,’ as this was perceived to be a more humane manner of death for the patient and their relatives. We argue that physician-assisted death can be justified also in some cases in which the death wish is part of the psychopathology, as the patient’s suffering can be unbearable and irremediable. Physician-assisted death in these cases may remain the only option left to relieve the suffering.
AB - Physician-assisted death for patients suffering from psychiatric disorders is allowed in the Netherlands under certain circumstances. One of the central problems that arise with regard to this practice is the question of whether it is possible to distinguish between suicidality and a request for physician-assisted death. We set up this study to gain insight into how psychiatrists and general practitioners distinguish between suicidality and physician-assisted death. The data for this study were collected through qualitative interviews with 20 general practitioners and 17 psychiatrists in the Netherlands. From the interviews, we conclude that physicians distinguish three types of death wishes among patients suffering from psychiatric disorders: ‘impulsive suicidality,’ ‘chronic suicidality,’ and ‘rational death wishes.’ To discern between them they evaluate whether the death wish is seen as part of the psychopathology, whether it is consistent over time, and whether they consider it treatable. Some considered physician-assisted death an alternative to a ‘rational suicide,’ as this was perceived to be a more humane manner of death for the patient and their relatives. We argue that physician-assisted death can be justified also in some cases in which the death wish is part of the psychopathology, as the patient’s suffering can be unbearable and irremediable. Physician-assisted death in these cases may remain the only option left to relieve the suffering.
KW - Euthanasia
KW - Netherlands
KW - Physician-assisted death
KW - Psychiatric patients
KW - Psychiatry
KW - Suicide
UR - http://www.scopus.com/inward/record.url?scp=85089731014&partnerID=8YFLogxK
U2 - https://doi.org/10.1007/s11013-020-09686-2
DO - https://doi.org/10.1007/s11013-020-09686-2
M3 - Article
C2 - 32833142
SN - 0165-005X
VL - 45
SP - 268
EP - 281
JO - Culture, medicine and psychiatry
JF - Culture, medicine and psychiatry
IS - 2
ER -