EPA-1542 - Physician-assisted Suicide and the Role of the Psychiatrists. a Medical Ethical Analysis

Abstract

Introduction

Physician-assisted suicide (PAS) is currently the subject of controversial discussion in many European countries, albeit only a few of them have legalized this end-of-life practice under certain conditions. For the main part, the people who ask for assistance in suicide suffer from incurable physical diseases. In rare cases, however, the suicide of patients who additionally or solely suffer from mental disorders is also assisted.

Objectives

The aim of this contribution is to describe potential roles of the psychiatrists in the context of PAS and to formulate ethical arguments for or against the respective involvement of psychiatrists in PAS.

Results

Some authors argue that psychiatrists, invoking the social responsibility for suicide prevention, should strictly reject any involvement in PAS and offer a psychiatric treatment to patients with suicide plans. Others see the role of the psychiatrists in assessing the patients’ competence, which constitutes a fundamental prerequisite for PAS from an ethical point of view. Moreover, others deem a medical prescription of a lethal drug and the assistance in suicide by psychiatrists for ethically acceptable under certain conditions.

Conclusion

We argue that psychiatrists are particularly well-suited to differentiate autonomous and non-autonomous suicide plans based on their expertise in the field of suicidology and in competence assessment. From an ethical point of view, the involvement of psychiatrists can thus contribute to quality assurance of a legalized practice of PAS, benefit the patient autonomy at the end of life and minimize risks of abuse.