In the Netherlands and Belgium, physician-assisted suicide (PAS) and euthanasia by lethal injection are being made available to psychiatric patients with non-terminal illnesses, commonly administered by their own treating psychiatrists giving the injection. Canada now offers PAS for non-terminal patients, and is on the verge of making it available to those with psychiatric disorders only. This raises profound ethical questions, for psychiatrists in particular, who have a core ethos to prevent suicide, help patients cope with suffering, find alternative paths to a better future, even make meaning of suffering. Allowing psychiatrists to help their patients with suicide inverts the fundamental ethical framework and very definition of what it means to be a psychiatrist.
This lecture examines the history of developments in Europe, Canada, and the U.S. regarding physician-assisted suicide and euthanasia of non-terminal psychiatric patients. Data from Belgium and Netherlands are reviewed. The positions of medical and psychiatric organizations around the world are shown. Fundamental ethical arguments in favor of such practices are contrasted with those against. Clinical, social, and professional consequences are reviewed, including some specific cases, relevant data, and evidence for a “slippery slope” of these practices. Finally, the way these practices challenge the fundamental identity of the psychiatric profession will be discussed, and how this is an unanticipated consequence of pursuing parity for the mentally ill.
Mark S. Komrad MD, DFAPA, FACP
Author of: “You Need Help: A Step-by-Step Plan to Convince a Loved One to Get Counseling”
Ethicist-in-Residence, Sheppard Pratt
APA Ethics Committee
Faculty of Psychiatry, Johns Hopkins and University of Maryland
Psychiatry Grand Rounds
Tuesday, April 25, 2017
11 a.m. to 12:30 pm.
Dean’s Conference Room
E & R Building
Camden