Medical assistance in dying

Sheehan, Kathleen; Gaind, K. Sonu; Downar, James

doi:10.1097/yco.0000000000000298

Cited by 22 publications

(8 citation statements)

References 21 publications

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“…Still, a more contentious issue not easily resolved, is whether debilitating mental disorders and their accompanying suffering can be deemed irremediable. At this time there are no agreed upon standards to define a mental disorder as irremediable (Sheehan et al, 2017). Features of hope are integral to the process of recovery when struggling with any mental disorder (Coppock et al, 2010; Prasko et al, 2015).…”

Section: Discussionmentioning

confidence: 99%

Clinical presentations of suicidality in relation to medical assistance in dying

Baylis,

Shaw,

Schatzmann

et al. 2023

Suicide & Life Threat Behav

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IntroductionThis study explores the assessments of mental health clinicians working with suicidal patients who requested access to medical assistance in dying (MAiD).MethodsA sample of convenience completed an online questionnaire about their experiences with suicidal patients. Respondents described their encounters with 227 suicidal patients: 44 requested access to MAiD, and 183 did not. Data were analyzed using chi‐squared and simple t‐test to identify differences between the respondents’ descriptions of the two groups.ResultsResults noted differences between patients who experience suicide ideation and request MAiD (SPM), and those who experience suicide ideation and do not (SP). Overall, the SPM group was older, more physical health concerns, chronic pain, existential distress, and less hope. Many had experienced several episodes of mental health care and medication trials, though unlike the SP group, they had a split between accessing a little care and a lot of care. They also engaged in less suicide planning, and some had no history of suicide attempts.ConclusionIt is important that mental health clinicians learn to differentiate between MAiD requests due to an ongoing and irremediable mental disorder, and MAiD requests in response to circumscribed psychological suffering that could be relieved via a change in circumstances and/or access to different treatment options amenable to the patient.

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Section: Discussionmentioning

confidence: 99%

Clinical presentations of suicidality in relation to medical assistance in dying

Baylis,

Shaw,

Schatzmann

et al. 2023

Suicide & Life Threat Behav

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“…Mehrere Autoren [25][26][27] weisen darauf hin, dass es eine große Herausforderung ist, eine subjektiv wahrgenommene Unerträglichkeit von Symptomen der psychischen Störung selbst oder von den verbundenen psychosozialen Faktoren (soziale Isolation, finanzielle Belastung, Arbeitslosigkeit, Verlust der Identität usw.) zu differenzieren.…”

Section: Präzisierung Von Psychiatrischem Leidenunclassified

Ärztlich assistierter Suizid für Menschen mit psychischen Störungen

Müller¹,

Stang²

2023

Nervenheilkunde

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ZUSAMMENFASSUNGGegenstand/Ziel: Mit dem Urteil des Bundesverfassungsgerichts von 2020 ist der rechtliche Rahmen für assistierten Suizid grundsätzlich gegeben; jedoch sind Fragen der Indikationsstellung bei Personen mit psychischer Störung noch ungeklärt. Der vorliegende Beitrag geht daher der Debatte nach, inwiefern der Forschungsstand den Zugang zu einem ärztlich assistierten Suizid auf Grundlage einer psychischen Störung als vertretbar bewertet.Methode: Die Fragestellung wurde mittels einer selektiven Literaturrecherche in den Datenbanken PubPsych und PubMed sowie durch das Schneeballsystem gefundener Studien der Länder mit Legalisierung beantwortet.Ergebnisse: Die psychiatrische Personengruppe kann anhand der gegenwärtigen Zugangsvoraussetzungen nicht kategorisch von ärztlich assistiertem Suizid ausgeschlossen werden. Der Rechtsanspruch sollte nur unter strengen Bewertungsverfahren im Rahmen zweier psychiatrischer unabhängiger Gutachten, professionellen Standards und zusätzlichen Sicherheitsvorkehrungen geltend gemacht werden.Schlussfolgerung: Es sollten berufsrechtliche Regelungen und Standards im Sinne von Leit- und Richtlinien geschaffen werden. Zudem kann ein themenspezifischer Bedarf an Aus-, Fort- und Weiterbildung von (Fach-)Ärzten und (Fach-)Psychotherapeuten postuliert werden.Klinische Relevanz: Das komplexe Unterfangen verlangt transparente Regelungen und Unterstützungsangebote für das Fachpersonal.

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“…The assessment of requests is the dimension of MAiD-MD that has received the most attention in the literature. The underlying moral concerns are manifold and relate to the complexity of the assessment of MAiD-MD requests [ 56 , 58 ]; as well as to the interpretation and application of eligibility criteria [ 6 , 56 ], mainly in relation to capacity [ 29 , 77 , 78 ], to the intolerability of suffering [ 17 , 56 , 64 , 70 ], and to the irremediability of the condition [ 47 , 51 ]. The vagueness of the concepts of incurability and irremediability, as well as the complexity of assessing the applicant’s level of appreciation of their situation, have also been highlighted [ 45 , 55 , 77 , 79 ].…”

Section: Maid-md Practicesmentioning

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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Medical assistance in dying

Cited by 22 publications

References 21 publications

Clinical presentations of suicidality in relation to medical assistance in dying

Clinical presentations of suicidality in relation to medical assistance in dying

Ärztlich assistierter Suizid für Menschen mit psychischen Störungen

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

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