RT Journal Article
SR Electronic
T1 Euthanasia requests, procedures and outcomes for 100 Belgian patients suffering from psychiatric disorders: a retrospective, descriptive study
JF BMJ Open
JO BMJ Open
FD British Medical Journal Publishing Group
SP e007454
DO 10.1136/bmjopen-2014-007454
VO 5
IS 7
A1 Lieve Thienpont
A1 Monica Verhofstadt
A1 Tony Van Loon
A1 Wim Distelmans
A1 Kurt Audenaert
A1 Peter P De Deyn
YR 2015
UL http://bmjopen.bmj.com/content/5/7/e007454.abstract
AB Objectives To identify patterns in euthanasia requests and practices relating to psychiatric patients; to generate recommendations for future research.Design Retrospective analysis of data obtained through medical file review.Setting Outpatient psychiatric clinical setting in the Dutch-speaking region of Belgium, between October 2007 and December 2011; follow-up at the end of December 2012.Participants 100 consecutive psychiatric patients requesting euthanasia based on psychological suffering associated with psychiatric disorders (77 women, 23 men; mean age 47 years; age range 21–80 years).Main outcome measures Patient sociodemographic characteristics; diagnoses; decisions on euthanasia requests; circumstances of euthanasia procedures; patient outcomes at follow-up.Results Most patients had been referred for psychiatric counselling by their physician (n=55) or by LEIF (Life End Information Forum) (n=36). 90 patients had >1 disorder; the most frequent diagnoses were depression (n=58) and personality disorder (n=50). 38 patients required further testing and/or treatment, including 13 specifically tested for autism spectrum disorder (ASD); 12 received an ASD diagnosis (all Asperger syndrome). In total, 48 of the euthanasia requests were accepted and 35 were carried out. Of the 13 remaining patients whose requests were accepted, 8 postponed or cancelled the procedure, because simply having this option gave them enough peace of mind to continue living. In December 2012, 43 patients had died, including 35 by euthanasia; others died by suicide (6), palliative sedation (1) and anorexia nervosa (1).Conclusions Depression and personality disorders are the most common diagnoses in psychiatric patients requesting euthanasia, with Asperger syndrome representing a neglected disease burden. Further research is needed, especially prospective quantitative and qualitative studies, to obtain a better understanding of patients with psychiatric disorders who request euthanasia due to unbearable psychological suffering.