University Center for Psychiatry, University Medical Centre Groningen, Groningen, The Netherlands
University Center for Psychiatry, University Medical Centre Groningen, Groningen, The Netherlands.
BMJ Case Rep. 2021 Aug 17;14(8):e239862. doi: 10.1136/bcr-2020-239862.
In the Netherlands, euthanasia or assisted suicide (EAS) in psychiatric disorders is legal in certain circumstances. Guidelines recommend a second opinion to independently check diagnosis and treatment resistance. A 68-year-old patient, diagnosed with bipolar I disorder, with a request for euthanasia because of tiredness, repeated falls and racing thoughts was seen for such a second opinion. Persisting in her wish, her reluctant family and psychiatrist became convinced of euthanasia. Our disagreement with the diagnosis of bipolar I disorder upset her, but she agreed with discontinuation of psychotropic drugs. Her mobility and tiredness improved, whereafter her request for euthanasia evolved into a death wish due to completed life. Intellectual disability and an attention deficit hyperactivity disorder could explain her struggle in life. This case report shows that extending the procedure regarding EAS with an independent psychiatric evaluation is important. For our patient, this second opinion supported her to find meaning in life.
在荷兰，某些情况下精神疾病的安乐死或协助自杀（EAS）是合法的。指南建议进行第二次意见检查，以独立检查诊断和治疗抵抗。一名 68 岁的患者被诊断为双相 I 型障碍，因疲劳、反复跌倒和思维奔逸而要求安乐死，因此进行了第二次意见检查。尽管她的家人和精神科医生不太愿意，但由于坚持自己的意愿，他们最终还是接受了安乐死的请求。我们对双相 I 型障碍的诊断提出异议，让她感到不安，但她同意停止使用精神药物。她的活动能力和疲劳感有所改善，此后，她的安乐死请求因生活已经圆满而变成了死亡愿望。智力残疾和注意力缺陷多动障碍可以解释她在生活中的挣扎。本病例报告表明，扩展与独立精神科评估有关的 EAS 程序非常重要。对于我们的患者，第二次意见检查支持她找到了生活的意义。
