How to deal with requests for assisted suicide: Some experiences and practical guidelines from the Netherlands.

Medical assistance in dying: implications for health systems from a scoping review of the literature

“…15,29,32,33 Seven articles examined the use of guidelines and/or frameworks to support decision-making. 13,17,21,26,[32][33][34] Werth et al argued that guidelines were necessary to aid psychological evaluations of mental condition(s) and capacity to consent 32 -a necessary criterion in some jurisdictions. All seven articles agreed that institutional and professional guidelines to support MAiD practices are necessary, but often underdeveloped or poorly integrated into existing health services.…”

“…All seven articles agreed that institutional and professional guidelines to support MAiD practices are necessary, but often underdeveloped or poorly integrated into existing health services. 13,17,21,26,[32][33][34] While many institutions appear to have practice guidelines, these were not always systematically disseminated to all stakeholders. 17 Six papers discussed concerns about physician adherence to MAiD policy.…”

“…Fifteen of the 35 articles discussed legal implementation issues 10,[14][15][16]20,[22][23][24][28][29][30][35][36][37][38] with 11 of 15 articles describing major challenges in determining patient capacity to request and consent to MAiD. 10,[14][15][16]21,23,29,30,35,37,38 While assessing competency is a major challenge in itself, handling requests from a person with a known mental or psychiatric disability presented additional legal complications in terms of meeting the requirement of informed consent, while simultaneously promoting equitable access. 28 Except in the Netherlands and Switzerland, individuals with varying levels of psychiatric disability were excluded from MAiD, causing some debate if this was an act of discrimination or a safeguard to protect vulnerable populations.…”

Euthanasia: the role of the psychiatrist

“…This means that the patient should be competent. However, the assessment of competence in a patient with a mental disorder is not straightforward, since the presence of mental disorder does not necessarily imply incompetence (Burgess & Hawton, 1998; Nederlandse Vereniging voor Psychiatrie, 1998; Kerkhof, 2000). Some examples are patients with recurrent depressive or psychotic episodes who are in symptom-free periods of recovery; patients suffering from isolated psychotic symptoms such as hallucinations, who have preserved enough awareness of the illness; and certain cases of chronic depression which are not characterised by low mood and nihilism but rather by psychomotor disabilities and sleep difficulties (Nederlandse Vereniging voor Psychiatrie, 1998).…”

İnti̇har Davranişinda Ri̇sk Faktörleri̇: Bi̇r Gözden Geçi̇rme

“…Ancak her ne kadar geçmiş intihar girişimi öyküsü önemli bir anahtar rol oynasa da, tamamlanmış inti ıarların üçte ikisinin ilk giri şimde gerçekleşmesi dikkat çekicidir (Kerkhof 2000).…”