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Tijdschrift voor Psychiatrie 53 (2011) 8, 543 - 550

Essay

Assisted suicide in psychiatry; current situation and notes on a recent case

A.P. de Boer, T.I. Oei

background The Dutch legal system grants psychiatric patients the right to assisted suicide but imposes strict conditions. The matter, however, remains controversial. Many psychiatrists are reluctant to become involved in assisted suicide because they are not familiar with the procedure that has to be followed, nor are they clear about the precise meaning of ‘acting responsibly’.
aim To provide an overview of the procedure to be followed and of the criteria to be met when a psychiatrist is wondering whether to grant a patient’s request for assistance with suicide.
method We analyse the law, jurisprudence and medical ethics and the special problems that arise in the case of psychiatric patients.
results We describe the developments in law and psychiatric practice which have led to greater recognition of the autonomy of the patient. The final decision depends on an assessment of the patient’s competence and his ability to articulate his request clearly and on the hopelessness engendered by unbearable suffering.
conclusion In the future there may be an increase in the number of cases of assisted suicide in psychiatry now that procedures and criteria have been established which are in accordance with the Dutch legal system.

keywords competence, euthanasia, hopelessness, physician-assisted suicide, unbearable suffering