Physician-assisted suicide and psychiatry

Abstract

Physician-assisted suicide (PAS) is the death of an individual that occurs as a result of deliberate, purposive actions taken by that individual, with the assistance of a physician. In the UK, assisting with the death of another individual is illegal, but other parts of the world, such as the state of Oregon in the USA, have laws that permit PAS in certain circumstances. In the Netherlands, PAS may be provided for either physical or psychiatric illness, although requests for PAS emanating from psychiatric practice rarely tend to be granted. PAS, especially in the context of psychiatric illness, raises a range of clinical, ethical, and legal issues for patients, families, healthcare providers. and society at large. Even in jurisdictions where PAS is not provided on the grounds of psychiatric illness alone, there is a range of other ways in which the issues surrounding PAS may come to the attention of psychiatrists and mental health teams. These include: requests to provide mental health care to individuals with terminal physical illness, who may or may not request PAS; requests to assess the capacity or capability of individuals with terminal physical illness who request PAS; and requests to assess, support, or treat families or staff members who have had involvement with PAS. There are important issues that merit close attention and point to a strong need for enhanced psychiatric liaison with terminal care providers.