D H
Sep 15 · Last update 12 days ago.

Should assisted-suicide be allowed for mental health patients?

In 2018, a Dutch 29 year-old, Aurelia Brouwers, was assisted in taking her own life, given a prescription by her doctor to end her life. Euthanasia is legal in the Netherlands under the 2002 Termination of Life on Request and Assisted Suicide Act, which through two doctor's assessments Brouwers was considered eligible for. In 2017, 83 of the 6,585 cases of euthanasia in the Netherlands were on the basis of psychiatric illness, not terminal medical conditions. But while this remains a minority, cases like Brouwers' have raised a lot of controversy over the interpretation of the Assisted Suicide Act. Should Dutch doctors be allowed to assist such troubled people in their suicide? Should euthanasia be allowed for mental health patients who are not terminally ill? bbc.com/news/stories-45117163
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No, this is sign of medical and legal failure
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No, this is sign of medical and legal failure

Under the 2002 Termination of Life on Request and Assisted Suicide Act Dutch doctors can assist the suicide of a patient whose suffering is “unbearable, with no prospect of improvement” and if there is “no reasonable alternative in the patient’s situation” [2]. However doctors are not infallible and their failure in such cases could lead to unnecessary death of patients, just because a doctor may lack the tools to deal with a patient's mental health problems, does not mean euthanasia should be a considered option. In the words of Dutch psychiatrist Dr Frank Koerselman, “How could I know - how could anybody know - that [Aurelia Brouwer's] death wish was not a sign of her psychiatric disease? ... the fact that one can rationalise about it, does not mean it's not a sign of the disease" [1].

Brouwers was a very ill woman who needed a lot of help, however while crying out for that help all she found was two doctors who agreed with her that there was no hope. She also found 'fans', people that supported her suicide online and encouraged her, and she slipped through a large hole in the Dutch social 'safety net' and legal system. Patients need doctors to represent hope at all costs, not to cater to their psychological delusions, doctors are not meant to give up hope but to represent hope to their patients against all the odds, doctors should hope to reach psychiatric patients not just give up on them. This case represents a gaping hole in the Netherland's legal framework of assisted suicide and mental health care, and this urgently needs reform.

[1] globalcomment.com/aurelia-brouwers-doctors-lawmakers-killed-instead-treating bmcpsychiatry.biomedcentral.com/articles/10.1186/s12888-019-2053-3 [2] worldrtd.net/sites/default/files/newsfiles/Leo%20Enthoven.pdf

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D H
Sep 25
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DH edited this paragraph
Under the 2002 Termination of Life on Request and Assisted Suicide Act Dutch doctors can assist the suicide of a patient whose suffering is “unbearable, with no prospect of improvement” and if there is “no reasonable alternative in the patient’s situation” [2]. However doctors are not infallible and their failure in such cases could lead to unnecessary death of patients, just because a doctor may lack the tools to deal with a patient's mental health problems, does not mean euthanasia should be a considered option. In the words of Dutch psychiatrist Dr Frank Koerselman, “How could I know - how could anybody know - that [Aurelia Brouwer's] death wish was not a sign of her psychiatric disease? ... the fact that one can rationalise about it, does not mean it's not a sign of the disease" [1].
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