PHYSICIAN-ASSISTED SUICIDE IN PSYCHIATRY - DEVELOPMENTS IN THE NETHERLANDS

Physician-assisted suicide can now be officially and legally cat-tied out for psychiatric patients in the Netherlands who request it, provid ed that criteria ape met. The authors describe two recent cases of psy chiatric patients whose suicides were assisted by their psychiatrist. They critically examine the guidelines for physician-assisted suicide in psychiatry. The criteria address the decision of the patient to be assisted with suicide, which must be voluntary and well considered, an d the patient's desire to die, which must endure over time. The patien t's suffering must be unacceptable, and the disorder incurable, The au thors conclude that important aspects of psychiatric practice are not addressed in the guidelines, which were originally developed for use i n somatic medicine. The assessment of treatment prognosis in psychiatr y is not accurate enough to allow. a final decision about incurability . Boundaries of the psychiatric therapeutic relationship are violated in physician-assisted suicide. The therapist's inability to objectivel y assess the patient's wish to die is overlooked. Because the general public will continue to ask for clarity on the issue of euthanasia and physician-assisted suicide, the authors believe that an open discussi on of both ethical and professional issues is the best option.