Provide Access to Information on Assisted Suicide for a Patient with a Diagnosis of Depression?

Winkler, Laura Al-Dakhiel; Wetterauer, Charlotte

doi:10.1024/1662-9647/a000259

Cited by 3 publications

(4 citation statements)

References 13 publications

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“…In the qualitative analysis, various domains emerged when (future) physicians were faced with this, including medical and social roles but especially personal motives in the decision-making process. In line with former research on guidelines for PAS in depressed patients, 47 respondents articulated a great need for guidance in their decision whether to provide PAS or not. This could facilitate a better separation of personal motives without undermining the ethical obligations in their professional role.…”

Section: Discussionmentioning

confidence: 73%

Perspectives on physician-assisted suicide in mental healthcare: results of a survey of physicians and medical students

Reichel,

Adam,

Ehni

et al. 2024

BJPsych open

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Background Physician-assisted suicide (PAS) is typically associated with serious physical illnesses that are prevalent in palliative care. However, individuals with mental illnesses may also experience such severity that life becomes intolerable. In February 2020, the previous German law prohibiting PAS was repealed. Patients with severe mental illnesses are increasingly likely to approach physicians with requests for PAS. Aims To explore the ethical and moral perspectives of medical students and physicians when making individual decisions regarding PAS. Method An anonymised digital survey was conducted among medical students and physicians in Germany. Participants were presented with a case vignette of a chronically depressed patient requesting PAS. Participants decided on PAS provision and assessed theoretical arguments. We employed generalised ordinal regression and qualitative analysis for data interpretation. Results A total of N = 1478 participants completed the survey. Of these, n = 470 (32%) stated that they would refuse the request, whereas n = 582 (39%) would probably refuse, n = 375 (25%) would probably agree and n = 57 (4%) would definitely agree. Patient-centred arguments such as the right to self-determination increased the likelihood of consent. Concerns that PAS for chronically depressed patients might erode trust in the medical profession resulted in a decreased willingness to provide PAS. Conclusions Participants displayed relatively low willingness to consider PAS in the case of a chronically depressed patient. This study highlights the substantial influence of theoretical medical-ethical arguments and the broader public discourse, underscoring the necessity of an ethical discussion on PAS for mental illnesses.

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Section: Discussionmentioning

confidence: 73%

Perspectives on physician-assisted suicide in mental healthcare: results of a survey of physicians and medical students

Reichel,

Adam,

Ehni

et al. 2024

BJPsych open

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“…Feeling that their suffering is acknowledged and having the opportunity to talk about their request for MAiD-MD can ease the suffering of people living with mental disorders, give them hope, build trust in the therapeutic relationship, and lead them to consider new therapeutic avenues, or decrease their desire to die [ 20 , 58 ]. This requires facilitating communication through deliberation and considering the important values of all stakeholders [ 65 , 70 ] as well as the needs of the MAiD-MD applicant. The issues of transference and countertransference should be addressed through professional consultations where the observations, feelings, and motivations of healthcare professionals would be shared with the consulted colleagues to gain better insight into possible situations of countertransference [ 71 ].…”

Section: Discussion On the Option Of Maid-mdmentioning

confidence: 99%

“…MAiD-MD may seem irreconcilable with the valuing of recovery-oriented approaches in mental health care [ 65 ], and some fear that its introduction into the continuum of care will cause a paradigm shift from a goal of improving quality of life towards a goal of assessing eligibility for MAiD-MD [ 28 ]. Helping people live with their mental disorders should precede MAiD-MD [ 66 ].…”

Section: Continuum Of Carementioning

confidence: 99%

Medical assistance in dying for people living with mental disorders: a qualitative thematic review

Favron-Godbout,

Racine

2023

BMC Med Ethics

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Background Medical assistance in dying (MAiD) sparks debate in several countries, some of which allow or plan to allow MAiD where a mental disorder is the sole underlying medical condition (MAiD-MD). Since MAiD-MD is becoming permissible in a growing number of jurisdictions, there is a need to better understand the moral concerns related to this option. Gaining a better understanding of the moral concerns at stake is a first step towards identifying ways of addressing them so that MAiD-MD can be successfully introduced and implemented, where legislations allow it. Methods Thus, this article aims (1) to better understand the moral concerns regarding MAiD-MD, and (2) to identify potential solutions to promote stakeholders’ well-being. A qualitative thematic review was undertaken, which used systematic keyword-driven search and thematic analysis of content. Seventy-four publications met the inclusion criteria. Results Various moral concerns and proposed solutions were identified and are related to how MAiD-MD is introduced in 5 contexts: (1) Societal context, (2) Healthcare system, (3) Continuum of care, (4) Discussions on the option of MAiD-MD, (5) MAiD-MD practices. We propose this classification of the identified moral concerns because it helps to better understand the various facets of discomfort experienced with MAiD-MD. In so doing, it also directs the various actions to be taken to alleviate these discomforts and promote the well-being of stakeholders. Conclusion The assessment of MAiD-MD applications, which is part of the context of MAiD-MD practices, emerges as the most widespread source of concern. Addressing the moral concerns arising in the five contexts identified could help ease concerns regarding the assessment of MAiD-MD.

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“…The authors provide a clinical case regarding a physician’s request for clinical ethics support when confronted with an aged patient with depression asking for information on assisted suicide. The article illustrates “the difficulties that arise in daily practice, the importance of guidance and support in view of controversy, the possibilities of finding pragmatic, acceptable solutions for all parties involved, and what clinical ethics consultation can contribute” (Winkler & Wetterauer, 2021, p. 57).…”

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confidence: 99%

Putting Medical Assistance in Dying to the Acid Test

Trachsel

Haberstroh

2021

GeroPsych

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The term "medical assistance in dying" originated in the Canadian law and is increasingly being used outside of Canada to encompass different practices such as euthanasia, physician-assisted suicide, or supporting persons during voluntary stopping eating and drinking (VSED). In euthanasia, which is only legal in The Netherlands, Belgium, and Luxembourg, the physician administers the drug; in assisted suicide or physician-assisted dying, physicians prescribe the lethal drug, which the persons willing to die then take by themselves; and in VSED, persons with preserved decision-making capacity who still have the physical ability to eat and drink consciously refuse foods and fluids to advance the time of their death.The legality of these different forms of medical assistance in dying vary considerably between countries and states, and there is also broad variation in the extent and specific characteristics of those who die an assisted death. Medical assistance in dying touches on existential questions, basic values and worldviews about human rights, life and death, personal autonomy, care for and protection of vulnerable persons, and solidarity. The topic is increasingly becoming relevant regarding the care and self-determination of the aged population. "To date, scholarly discourse on [medical assistance in dying] has been dominated by issues such as decision-making capacity, uncertainty as to when a disease is incurable, stigmatization, isolation, and loneliness" (Stoll et al., 2021, p. 1).This special provides a platform for empirical and empirically substantiated conceptual articles to discuss different forms of medical assistance in dying from an international and interdisciplinary perspective and to put crucial aspects to the acid test.The special issue includes five articles. In their contribution, Laura Winkler and Charlotte Wetterauer focus on assisted suicide as a controversially discussed topic in medical ethics, particularly when it comes to patients with mental disorders. The authors provide a clinical case regarding a

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Provide Access to Information on Assisted Suicide for a Patient with a Diagnosis of Depression?

Cited by 3 publications

References 13 publications

Perspectives on physician-assisted suicide in mental healthcare: results of a survey of physicians and medical students

Perspectives on physician-assisted suicide in mental healthcare: results of a survey of physicians and medical students

Medical assistance in dying for people living with mental disorders: a qualitative thematic review

Putting Medical Assistance in Dying to the Acid Test

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