van Veen S M P, Weerheim F W, Mostert M, van Delden J J M
Tijdschr Psychiatr. 2019;61(4):241-247.
The Netherlands is one of the few countries in the world that allows euthanasia and assisted suicide (EAS) due to psychiatric suffering. METHODS In 2015-2017 the Dutch regional euthanasia review committees published 43 case summaries online. Of these, 35 were suitable for analysis regarding patient characteristics and physician involvement, and 3 cases were described in detail.
RESULTS: In total, 77% of the patients were women and 51% were aged 50-70 years. Major depression disorder and personality disorders were present in almost half of the patients. All patients were considered mentally competent. CONCLUSIONS Although the incidence of psychiatric EAS cases is rising, we found no shift in patient characteristics. The division between psychiatric and somatic suffering may prove more complicated than expected. Patients dying from suicide differ in various ways from patients dying through EAS. The fact that all patients are considered competent could mean that they are unjustly seen as being vulnerable or that the competence assessment lacks due diligence.
荷兰是世界上少数几个允许因精神痛苦而实施安乐死和协助自杀(EAS)的国家之一。方法:2015年至2017年,荷兰地区安乐死审查委员会在网上公布了43例病例摘要。其中,35例适合就患者特征和医生参与情况进行分析,3例进行了详细描述。结果:总体而言,77%的患者为女性,51%的患者年龄在50至70岁之间。近一半的患者患有重度抑郁症和人格障碍。所有患者都被认为具有精神行为能力。结论:尽管精神疾病安乐死和协助自杀病例的发生率在上升,但我们发现患者特征没有变化。精神痛苦和躯体痛苦之间的区分可能比预期的更为复杂。死于自杀的患者与通过安乐死和协助自杀死亡的患者在各种方面存在差异。所有患者都被认为具有行为能力这一事实可能意味着他们被不公正地视为弱势群体,或者行为能力评估缺乏应有的审慎。