The terminal, the futile, and the psychiatrically disordered

Cholbi, Michael

doi:10.1016/j.ijlp.2013.06.011

Cited by 22 publications

(20 citation statements)

References 29 publications

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“…This was true for 80% (16/20) of publications in favor of psychiatric EAS, largely (87%) written from countries where some form of legal EAS exists for physical disorders, such as the USA, Canada and Australia. Most authors who argued for parity between mental and physical illness were non-clinicians also arguing for parity between mental and physical suffering (Cholbi, 2013; Dembo, Schuklenk, & Reggler, 2018; Hirsch, 2016; Player, 2018; Provencher-Renaud, Larivée, & Sénéchal, 2019; Sagan, 2015; Schuklenk & van de Vathorst, 2015a; Steinbock, 2017; Tanner, 2018; Varelius, 2016a). Parity reasons largely relied on the assumption that suffering is the justification for EAS in terminal, physical illness.…”

Section: Discussionmentioning

confidence: 99%

“…Some authors in favor, mostly non-clinicians, argued that parity requires extending EAS laws to include persons with mental illness as a matter of principle. Hence, the possibility of false positives should be tolerated to reduce overall suffering (Cholbi, 2013; Provencher-Renaud et al, 2019; Reel, 2018; Rooney, Schuklenk, & van de Vathorst, 2018; Sagan, 2015; Schuklenk & van de Vathorst, 2015a; Tanner, 2018). Other authors in favor of the practice instead raised policy concerns (Steinbock, 2017; Vandenberghe, 2018).…”

Section: Discussionmentioning

confidence: 99%

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Should euthanasia and assisted suicide for psychiatric disorders be permitted? A systematic review of reasons

et al. 2020

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BackgroundEuthanasia and assisted suicide (EAS) based on a psychiatric disorder (psychiatric EAS) continue to pose ethical and policy challenges, even in countries where the practice has been allowed for years. We conducted a systematic review of reasons, a specific type of review for bioethical questions designed to inform rational policy-making. Our aims were twofold: (1) to systematically identify all published reasons for and against the practice (2) to identify current gaps in the debate and areas for future research.MethodsFollowing the PRISMA guidelines, we performed a search across seven electronic databases to include publications focusing on psychiatric EAS and providing ethical reasons. Reasons were grouped into domains by qualitative content analysis.ResultsWe included 42 articles, most of which were written after 2013. Articles in favor and against were evenly distributed. Articles in favor were mostly full-length pieces written by non-clinicians, with articles against mostly reactive, commentary-type pieces written by clinicians. Reasons were categorized into eight domains: (1) mental and physical illness and suffering (2) decisional capacity (3) irremediability (4) goals of medicine and psychiatry (5) consequences for mental health care (6) psychiatric EAS and suicide (7) self-determination and authenticity (8) psychiatric EAS and refusal of life-sustaining treatment. Parity- (or discrimination-) based reasons were dominant across domains, mostly argued for by non-clinicians, while policy reasons were mostly pointed to by clinicians.ConclusionsThe ethical debate about psychiatric EAS is relatively young, with prominent reasons of parity. More direct engagement is needed to address ethical and policy considerations.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Should euthanasia and assisted suicide for psychiatric disorders be permitted? A systematic review of reasons

et al. 2020

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“…As psychiatrists (MN and SK) we do not disagree with the statement. 2 What we question is the accompanying assertion that to argue against PPAD amounts to not taking suffering seriously (Cholbi 2013;Kious and Battin 2019;Provencher-Renaud et al 2018;Schuklenk and van de Vathorst 2015;Tanner 2018). Such an assertion has rhetorical force but cannot support the parity argument since it makes sense only if the parity argument is already seen as valid.…”

Section: The Meanings Of 'Suffering' and Their Uses In The Parity Argumentmentioning

confidence: 99%

“…Most parity arguments for PPAD assert some version of 'mental suffering is as bad as or worse than physical suffering' (Cholbi 2013;Dembo 2010;Dembo et al 2018;Hirsch 2016;Parker 2013;Provencher-Renaud et al 2018;Sagan 2015;Steinbock 2017;Tanner 2018;Varelius 2016). As psychiatrists (MN and SK) we do not disagree with the statement.…”

Section: The Meanings Of 'Suffering' and Their Uses In The Parity Argumentmentioning

confidence: 99%

“…argue that psychiatric PAD (PPAD) should be legal in the US, based on a 'parity' argument (Kious and Battin 2019). This is the most popular approach to argue for PPAD (Cholbi 2013;Dembo 2010;Dembo et al 2018;Hirsch 2016;Parker 2013;Provencher-Renaud et al 2018;Rooney et al 2018;Schuklenk and van de Vathorst 2015;Tanner 2018;Varelius 2016). What K&B add is that since, in their view, the parity argument is valid, there is a dilemma because PPAD conflicts with the practice of involuntary commitment in psychiatry.…”

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confidence: 99%

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