Dr. Hanif is a Forensic Psychiatry Fellow, Dr. McNiel is a Professor of Clinical Psychology, and Dr. Binder is a Professor of Psychiatry and Director of the Psychiatry and the Law Program, University of California, San Francisco, San Francisco, CA. Dr. Weithorn is a Professor of Law and the Harry & Lillian Hastings Research Chair, University of California Hastings College of Law, San Francisco, CA.
J Am Acad Psychiatry Law. 2024 Sep 3;52(3):347-357. doi: 10.29158/JAAPL.240042-24.
In recent years, several jurisdictions have passed legislation to permit medical aid in dying (MAID) worldwide, with considerable expansion in the availability of this practice. MAID has been defined as the practice of a clinician prescribing lethal drugs in response to a direct request from the patient, with a shared understanding that the patient intends to use the medication to bring about the patient's death. Wider legalization of MAID has prompted debates and legal controversies regarding the extent to which MAID should be available and its application for people experiencing mental illness as the primary indication. This article examines shifting attitudes of professional medical organizations toward MAID. We discuss the existing statutory provisions for psychiatric assessment for MAID in the United States and the implications on such assessments should MAID be expanded to include mental illness as the primary indication. This article also assesses legal disputes concerning MAID regulations and explores the role of psychiatric experts in the practice of MAID.
近年来,世界上有几个司法管辖区通过立法允许医疗协助自杀(MAID),这种做法的可及性有了相当大的扩大。MAID 被定义为临床医生根据患者的直接请求开出致命药物的做法,双方共同理解患者打算使用药物来结束自己的生命。MAID 的更广泛合法化引发了关于 MAID 应该在多大程度上可用及其在将精神疾病作为主要指征的人群中的应用的争论和法律争议。本文探讨了专业医疗组织对 MAID 的态度转变。我们讨论了美国目前针对 MAID 进行精神病评估的法定条款,以及如果将 MAID 扩大到将精神疾病作为主要指征,对这种评估的影响。本文还评估了有关 MAID 法规的法律争议,并探讨了精神病专家在 MAID 实践中的作用。