Persons with mental disorders and assisted dying practices in Spain: An overview

Pozón, Sergio Ramos; Terribas-Sala, Núria; Falcó‐Pegueroles, Anna; Román-Maestre, Begoña

doi:10.1016/j.ijlp.2023.101871

Cited by 6 publications

(3 citation statements)

References 29 publications

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“…Participants' attitudes towards patient autonomy and patient suffering had a significant influence on their decision regarding the provision or refusal of PAS, as did their professional ethics and possible consequences for the physician-patient relationship, as well as perceived societal pressure. Physicians' personal autonomy (14) Personal conscience (162) Medical task (30) Not a medical task (165) Judgement about a 'life worth living' (48)…”

Section: Factors Influencing Attitudes Towards Pasmentioning

confidence: 99%

“…11 Although PAS was initially intended for those suffering from physical illness or in palliative care, the international debate has gradually expanded to include people with mental illness as eligible for PAS. [12][13][14] Suicide and suicidal ideation form a distinct syndrome that is found in a variety of mental illnesses, with major depression being the most prevalent. Suicidal tendencies are often reported during depressive episodes, with a risk of suicide of around 15%.…”

mentioning

confidence: 99%

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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 In February 2020, the previous German law prohibiting PAS was repealed.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: Factors Influencing Attitudes Towards Pasmentioning

confidence: 99%

mentioning

confidence: 99%

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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“…Belgium, The Netherlands, Luxembourg, and Switzerland have allowed people living with mental disorders to access some forms of MAiD for years [ 2 ]. More recently, Spain has passed a MAiD law making people living with mental disorders eligible for MAiD under certain conditions [ 3 ]. Canada has decriminalized MAiD for physical conditions and plans to allow MAiD when a mental disorder is the sole underlying medical condition (MAiD-MD) [ 4 ].…”

Section: Introductionmentioning

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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Persons with mental disorders and assisted dying practices in Spain: In response to Ramos et al.

Pifarre,

Esquerda,

Torralba

et al. 2024

International Journal of Law and Psychiatry

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Persons with mental disorders and assisted dying practices in Spain: An overview

Cited by 6 publications

References 29 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

Persons with mental disorders and assisted dying practices in Spain: In response to Ramos et al.

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