jeudi 11 mars 2021

ETUDE ET RECHERCHE Euthanasia and assisted suicide in psychiatric patients: A systematic review of the literature

Review article Euthanasia and assisted suicide in psychiatric patients: A systematic review of the literature
Raffaella Calati abcde Emilie Olié cde Déborah Dassa cd Carla Gramaglia fg Sébastien Guillaume cde Fabio Madeddu a Philippe Courtetcde
Journal of Psychiatric Research

a
Department of Psychology, University of Milan-Bicocca, Milan, Italy
b
Department of Adult Psychiatry, Nîmes University Hospital, Nîmes, France
c
PSNREC, University of Montpellier, INSERM, CHU Montpellier, Montpellier, France
d
Department of Emergency Psychiatry and Acute Care, Lapeyronie Hospital, CHU Montpellier, Montpellier, France
e
FondaMental Foundation, Créteil, France
f
Department of Translational Medicine, Institute of Psychiatry, University of Eastern Piedmont, Novara, Italy
g
Psychiatry Ward, Maggiore della Carità University Hospital, Novara, Italy

Highlights

• Features of psychiatric patients having received Euthanasia or Assisted Suicide (pEAS) were different across countries.
• In the Netherlands the percentage of pEAS cases increased from 0% to 1.1% (from 0 to 68) in 2009–2019.
• In Belgium the percentage of pEAS cases increased from 0% to 2.2% (from 0 to 40) in 2002–2013.
• Mood disorders were mainly represented.
• Cases of pEAS seem to be very similar to ‘traditional suicides’.

Abstract

The number of psychiatric patients requesting Euthanasia or Assisted Suicide (EAS) continues to increase. The aims of this systematic review were to: 1) describe the available data related to psychiatric patients having received or requesting EAS (pEAS) for each country in which is allowed; 2) and describe the ethically salient points that arise.

PubMed, PsycINFO, and Scopus databases were searched to identify articles published up to September 2020. Among the retrieved publications, only studies on pEAS cases (pEAS-C), pEAS requests, or physician reports/attitude towards pEAS reporting some quantitative data on patients having received or requesting pEAS were retained. Among the 24 included studies, thirteen (54%) were about pEAS in the Netherlands, four (17%) in Belgium, and seven (29%) in Switzerland. Results were different across different countries. In the Netherlands, pEAS-C were mostly women (70–77%) and often had at least two psychiatric disorders (56–97%). Mood disorders were mainly represented (55–70%) together with personality disorders (52–54%). History of suicide attempts was present in 34–52%. Moreover, 37–62% of them had at least one comorbid medical condition. In Belgium pEAS-C were mostly women (75%), but the majority (71%) had a single diagnosis, mood disorder. In Switzerland available data were less detailed.

As pEAS-C seem to be very similar to ‘traditional suicides’, pEAS procedures should be carefully revised to establish specific criteria of access and guidelines of evaluation of the request. A deeper focus on unbearable suffering, decision capacity and possibilities of improvements is warranted as well as the involvement of mental health professionals.

Keywords Euthanasia Assisted suicide End-of-life care Psychiatric disorders Depression

https://www.sciencedirect.com/science/article/abs/pii/S0022395620311146?via%3Dihub