Roff Chelsea, Cook-Cottone Catherine
Eat Breathe Thrive, London, United Kingdom.
Department of Counseling, School, and Educational Psychology, University at Buffalo, Buffalo, NY, United States.
Front Psychiatry. 2024 Jul 31;15:1431771. doi: 10.3389/fpsyt.2024.1431771. eCollection 2024.
Assisted dying for reasons solely related to an eating disorder (ED) has occurred in multiple countries, including those which restrict the practice to individuals with a terminal condition. The aims of this systematic review were to (1) identify all known cases of assisted deaths among patients with EDs and (2) describe the clinical rationales used to grant patients' requests for assisted death.
We conducted a systematic search of peer-reviewed studies and publicly available government reports to identify cases of assisted death in patients with EDs. In reports that included qualitative data about the case, clinical rationales were extracted and grouped into domains by qualitative content analysis.
We identified 10 peer-reviewed articles and 20 government reports describing at least 60 patients with EDs who underwent assisted dying between 2012 and 2024. Clinical rationales were categorized into three domains: irremediability, terminality, and voluntary request. Reports emphasized that patients with EDs who underwent assisted death had terminal, incurable, and/or untreatable conditions and had adequate decision-making capacity to make a life-ending decision. Most government reports did not include descriptive-enough data to verify psychiatric conditions.
The results of our systematic review underscore considerable gaps in the reporting of assisted death in patients with psychiatric conditions, posing substantial concerns about oversight and public safety. In many cases, the clinical rationales that were used to affirm patients with EDs were eligible for assisted death lack validity and do not cohere with empirical understanding.
在包括那些将协助死亡限制于患有终末期疾病个体的多个国家，已经出现了仅因饮食失调（ED）而进行的协助死亡情况。本系统评价的目的是：（1）识别饮食失调患者中所有已知的协助死亡案例；（2）描述用于批准患者协助死亡请求的临床理由。
我们对同行评审研究和公开可得的政府报告进行了系统检索，以识别饮食失调患者的协助死亡案例。在包含有关案例定性数据的报告中，提取临床理由并通过定性内容分析将其分组到各个领域。
我们识别出10篇同行评审文章和20份政府报告，描述了2012年至2024年间至少60名接受协助死亡的饮食失调患者。临床理由被分为三个领域：不可治愈性、终末期和自愿请求。报告强调，接受协助死亡的饮食失调患者患有终末期、无法治愈和/或不可治疗的疾病，并且具有做出结束生命决定的足够决策能力。大多数政府报告没有包含足够详细的数据来核实精神状况。
我们系统评价的结果突显了精神疾病患者协助死亡报告方面的巨大差距，引发了对监督和公共安全的重大担忧。在许多情况下，用于确认饮食失调患者有资格获得协助死亡的临床理由缺乏有效性，并且与实证理解不一致。
