Euthanasia: Should psychiatric patients be systematically excluded?

An increase of the number of psychiatric patients requesting euthanasia or assisted suicide (EAS) has been reported in countries practicing EAS. The debate raised by EAS invites psychiatrists to think about their role in this societal issue. If euthanasia for patients with unbearable somatic suffering is the subject of fierce ethical debate, the debate is even fiercer in cases of unbearable psychiatric suffering. In this manuscript, we discuss 3 main points concerning EAS for psychiatric patients. First, we question the notion of irreversibility of the condition and the related medical futility. Second, we focus on the capacity to make informed decisions in such situations. Third, we ask whether psychiatric EAS should be considered as a copycat of traditional suicide or an additional therapeutic alternative. Psychiatrists should produce practice guidelines to be involved in the EAS debate and develop research programs.