The DOI matches its Crossref record; 24 of the 26 references it cites were found in a registry or an index; none of the 25 sources its claims cite is checked for support yet.
Euthanasia and Assisted Suicide of Patients With Psychiatric Disorders in the Netherlands 2011 to 2014
Open accessAbstract
IMPORTANCE: Euthanasia or assisted suicide (EAS) of psychiatric patients is increasing in some jurisdictions such as Belgium and the Netherlands. However, little is known about the practice, and it remains controversial. OBJECTIVES: To describe the characteristics of patients receiving EAS for psychiatric conditions and how the practice is regulated in the Netherlands. DESIGN, SETTING, AND PARTICIPANTS: This investigation reviewed psychiatric EAS case summaries made available online by the Dutch regional euthanasia review committees as of June 1, 2015. Two senior psychiatrists used directed content analysis to review and code the reports. In total, 66 cases from 2011 to 2014 were reviewed. MAIN OUTCOMES AND MEASURES: Clinical and social characteristics of patients, physician review process of the patients' requests, and the euthanasia review committees' assessments of the physicians' actions. RESULTS: Of the 66 cases reviewed, 70% (n = 46) were women. In total, 32% (n = 21) were 70 years or older, 44% (n = 29) were 50 to 70 years old, and 24% (n = 16) were 30 to 50 years old. Most had chronic, severe conditions, with histories of attempted suicides and psychiatric hospitalizations. Most had personality disorders and were described as socially isolated or lonely. Depressive disorders were the primary psychiatric issue in 55% (n = 36) of cases. Other conditions represented were psychotic, posttraumatic stress or anxiety, somatoform, neurocognitive, and eating disorders, as well as prolonged grief and autism. Comorbidities with functional impairments were common. Forty-one percent (n = 27) of physicians performing EAS were psychiatrists. Twenty-seven percent (n = 18) of patients received the procedure from physicians new to them, 14 of whom were physicians from the End-of-Life Clinic, a mobile euthanasia clinic. Consultation with other physicians was extensive, but 11% (n = 7) of cases had no independent psychiatric input, and 24% (n = 16) of cases involved disagreement among consultants. The euthanasia review committees found that one case failed to meet legal due care criteria. CONCLUSIONS AND RELEVANCE: Persons receiving EAS for psychiatric disorders in the Netherlands are mostly women and of diverse ages, with complex and chronic psychiatric, medical, and psychosocial histories. The granting of their EAS requests appears to involve considerable physician judgment, usually involving multiple physicians who do not always agree (sometimes without independent psychiatric input), but the euthanasia review committees generally defer to the judgments of the physicians performing the EAS.
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A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“In 16 cases with physician disagreements, the RTE specifically addressed the disagreement in their Assessment in 2 cases.”
§ Euthanasia and Assisted Suicide of Patients with Psychiatric Disorders in the Netherlands 2011–2014 > RESULTS > Review Committee Actions
Strength:plain· not yet calibratedn = 16Tests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesA result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“In half the cases, more than one official EAS consultant was involved”
§ Euthanasia and Assisted Suicide of Patients with Psychiatric Disorders in the Netherlands 2011–2014 > RESULTS > Consultations and Second Opinions
Strength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesIn the paper
“It also contrasts with 43% women/57% men ratio in overall Dutch EAS recipients.22”
§ Euthanasia and Assisted Suicide of Patients with Psychiatric Disorders in the Netherlands 2011–2014 > DISCUSSION
What the sources say
- Not matchedcites [22]
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
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In the paper
“The majority (52%) had made suicide attempts”
§ Euthanasia and Assisted Suicide of Patients with Psychiatric Disorders in the Netherlands 2011–2014 > RESULTS > Characteristics of Patients
Strength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesA result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“There were disagreements among the physicians in 16 cases (24%).”
§ Euthanasia and Assisted Suicide of Patients with Psychiatric Disorders in the Netherlands 2011–2014 > RESULTS > Disagreement Among Physicians
Strength:plain· not yet calibratedn = 16Tests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesA result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“all except one official consultant were SCEN physicians”
§ Euthanasia and Assisted Suicide of Patients with Psychiatric Disorders in the Netherlands 2011–2014 > RESULTS > Consultations and Second Opinions
Strength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesA result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Depressive conditions were the primary psychiatric issue in 36 cases (55%).”
- Also stated in: § Results · plain
“Depressive disorders were the primary issue in 55% of cases.”
§ Euthanasia and Assisted Suicide of Patients with Psychiatric Disorders in the Netherlands 2011–2014 > RESULTS > Characteristics of Patients
Strength:plain· not yet calibratedn = 36Tests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passes- Also stated in: § Results · plain
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“32% were over 70 years-old”
- Also stated in: § Characteristics of Patients · plain
“32% were 70 or older”
§ Euthanasia and Assisted Suicide of Patients with Psychiatric Disorders in the Netherlands 2011–2014 > Abstract > Results
Strength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passes- Also stated in: § Characteristics of Patients · plain
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“In 8 cases, a psychiatrist consultant believed due care criteria were not met while a primary care consultant believed that the criteria were met.”
§ Euthanasia and Assisted Suicide of Patients with Psychiatric Disorders in the Netherlands 2011–2014 > RESULTS > Disagreement Among Physicians
Strength:plain· not yet calibratedn = 8Tests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesA result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“44% were between 50–70”
- Also stated in: § Characteristics of Patients · plain
“44% were between 50 and 70”
§ Euthanasia and Assisted Suicide of Patients with Psychiatric Disorders in the Netherlands 2011–2014 > Abstract > Results
Strength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passes- Also stated in: § Characteristics of Patients · plain
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The Assessment section of the case report—which discusses whether the notifying physician’s actions conform to the due care criteria—employed language without any case-specific elements in 43 reports (65%).”
§ Euthanasia and Assisted Suicide of Patients with Psychiatric Disorders in the Netherlands 2011–2014 > RESULTS > Review Committee Actions
Strength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesA result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“In the 7 cases without independent psychiatric opinion, the Assessment section addressed that issue in 3 cases.”
§ Euthanasia and Assisted Suicide of Patients with Psychiatric Disorders in the Netherlands 2011–2014 > RESULTS > Review Committee Actions
Strength:plain· not yet calibratedn = 7Tests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesA result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“In 7 cases (11%), no independent psychiatric expert was involved”
§ Euthanasia and Assisted Suicide of Patients with Psychiatric Disorders in the Netherlands 2011–2014 > RESULTS > Consultations and Second Opinions
Strength:plain· not yet calibratedn = 7Tests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesA result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Monoamine oxidase-inhibitor treatment was mentioned (or implied where the report explicitly said all medications in the Dutch Psychiatric Association Guidelines were tried) in 7 cases (11%).”
§ Euthanasia and Assisted Suicide of Patients with Psychiatric Disorders in the Netherlands 2011–2014 > RESULTS > Treatment and Refusal
Strength:plain· not yet calibratedn = 7Tests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesA result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“80% had been psychiatrically hospitalized in the past”
§ Euthanasia and Assisted Suicide of Patients with Psychiatric Disorders in the Netherlands 2011–2014 > RESULTS > Characteristics of Patients
Strength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesA result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Personality disorders were more common in persons under 60 years (66% vs 41%, Fisher’s exact test, p=0.05).”
§ Euthanasia and Assisted Suicide of Patients with Psychiatric Disorders in the Netherlands 2011–2014 > RESULTS > Characteristics of Patients
Strength:plain· not yet calibratedCausal:correlational· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesA result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The patients’ psychiatric conditions were chronic.”
§ Euthanasia and Assisted Suicide of Patients with Psychiatric Disorders in the Netherlands 2011–2014 > RESULTS > Characteristics of Patients
Strength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesThe paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“thus 17 of 66 (26%) patients had some form of psychosis”
§ Euthanasia and Assisted Suicide of Patients with Psychiatric Disorders in the Netherlands 2011–2014 > RESULTS > Characteristics of Patients
Strength:plain· not yet calibratedn = 66Tests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesA result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“In 7 of these 8 cases, the EAS physician was a psychiatrist.”
§ Euthanasia and Assisted Suicide of Patients with Psychiatric Disorders in the Netherlands 2011–2014 > RESULTS > Disagreement Among Physicians
Strength:plain· not yet calibratedn = 8Tests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesA result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“38 patients (58%) had at least one co-morbid medical condition”
§ Euthanasia and Assisted Suicide of Patients with Psychiatric Disorders in the Netherlands 2011–2014 > RESULTS > Characteristics of Patients
Strength:plain· not yet calibratedn = 38Tests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesA result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“PTSD-related and other anxiety disorders were prominent (28 of 66 patients, 42%).”
§ Euthanasia and Assisted Suicide of Patients with Psychiatric Disorders in the Netherlands 2011–2014 > RESULTS > Characteristics of Patients
Strength:plain· not yet calibratedn = 66Tests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesA result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“most (56%) also refused at least some treatment”
§ Euthanasia and Assisted Suicide of Patients with Psychiatric Disorders in the Netherlands 2011–2014 > RESULTS > Treatment and Refusal
Strength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesA result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“70% (46 of 66) of patients were women”
- Also stated in: § Characteristics of Patients · plain
“70% of the patients were women”
§ Euthanasia and Assisted Suicide of Patients with Psychiatric Disorders in the Netherlands 2011–2014 > Abstract > Results
Strength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passes- Also stated in: § Characteristics of Patients · plain
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Psychiatrists served as one of the official independent EAS consultants in 39 cases (59%).”
§ Euthanasia and Assisted Suicide of Patients with Psychiatric Disorders in the Netherlands 2011–2014 > RESULTS > Consultations and Second Opinions
Strength:plain· not yet calibratedn = 39Tests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesA result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“in 27 patients (41%) approximately 11–30 years”
§ Euthanasia and Assisted Suicide of Patients with Psychiatric Disorders in the Netherlands 2011–2014 > RESULTS > Characteristics of Patients
Strength:plain· not yet calibratedn = 27Tests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesA result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“22 patients (33%) had at least 2 co-morbidities”
§ Euthanasia and Assisted Suicide of Patients with Psychiatric Disorders in the Netherlands 2011–2014 > RESULTS > Characteristics of Patients
Strength:plain· not yet calibratedn = 22Tests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesA result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“In 27 cases (41%), the physician performing EAS was a psychiatrist”
§ Euthanasia and Assisted Suicide of Patients with Psychiatric Disorders in the Netherlands 2011–2014 > RESULTS > Consultations and Second Opinions
Strength:plain· not yet calibratedn = 27Tests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesA result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“in 18 patients (27%) longer than 30 years.”
§ Euthanasia and Assisted Suicide of Patients with Psychiatric Disorders in the Netherlands 2011–2014 > RESULTS > Characteristics of Patients
Strength:plain· not yet calibratedn = 18Tests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesA result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The RTE found that only one of the 110 (0.9%) of all reported psychiatric cases failed to meet due care criteria”
§ Euthanasia and Assisted Suicide of Patients with Psychiatric Disorders in the Netherlands 2011–2014 > RESULTS > Review Committee Actions
Load-bearingStrength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesA result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“26 patients (39%) received ECT at some point.”
§ Euthanasia and Assisted Suicide of Patients with Psychiatric Disorders in the Netherlands 2011–2014 > RESULTS > Treatment and Refusal
Strength:plain· not yet calibratedn = 26Tests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesA result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Notably 4 persons (6%) had cognitive impairment”
§ Euthanasia and Assisted Suicide of Patients with Psychiatric Disorders in the Netherlands 2011–2014 > RESULTS > Characteristics of Patients
Strength:plain· not yet calibratedn = 4Tests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesA result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“In 5 patients (7.6%) the psychiatric history was approximately 5 years or less”
§ Euthanasia and Assisted Suicide of Patients with Psychiatric Disorders in the Netherlands 2011–2014 > RESULTS > Characteristics of Patients
Strength:plain· not yet calibratedn = 5Tests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesA result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Consultation with an independent psychiatrist either as EAS consultant or as second opinion occurred in 59 cases (89%).”
§ Euthanasia and Assisted Suicide of Patients with Psychiatric Disorders in the Netherlands 2011–2014 > RESULTS > Consultations and Second Opinions
Strength:plain· not yet calibratedn = 59Tests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesA result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“In 37 patients (56%), the reports mentioned the patients’ social isolation or loneliness”
§ Euthanasia and Assisted Suicide of Patients with Psychiatric Disorders in the Netherlands 2011–2014 > RESULTS > Characteristics of Patients
Strength:plain· not yet calibratedn = 37Tests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesA result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Most patients had more than one condition (37 had at least 2, 11 had at least 3, and 4 had 4).”
§ Euthanasia and Assisted Suicide of Patients with Psychiatric Disorders in the Netherlands 2011–2014 > RESULTS > Characteristics of Patients
Strength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesA result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“21 patients (32%) had been refused EAS at some point.”
§ Euthanasia and Assisted Suicide of Patients with Psychiatric Disorders in the Netherlands 2011–2014 > RESULTS > EAS Refusal History and End-of-Life Clinic
Strength:plain· not yet calibratedn = 21Tests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesA result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“In 14 cases, the new physician was affiliated with the End-of-Life Clinic.”
§ Euthanasia and Assisted Suicide of Patients with Psychiatric Disorders in the Netherlands 2011–2014 > RESULTS > EAS Refusal History and End-of-Life Clinic
Strength:plain· not yet calibratedn = 14Tests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesA result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“34 patients (52%) had personality-related problems”
§ Euthanasia and Assisted Suicide of Patients with Psychiatric Disorders in the Netherlands 2011–2014 > RESULTS > Characteristics of Patients
Strength:plain· not yet calibratedn = 34Tests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesA result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“In 41% (29 of 66) of cases, there were no official EAS consultants who were psychiatrists”
§ Euthanasia and Assisted Suicide of Patients with Psychiatric Disorders in the Netherlands 2011–2014 > DISCUSSION
Strength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesA result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“in 11% (7 of 66) of cases, there were no independent psychiatrists involved as EAS consultants or second opinion consultants.”
§ Euthanasia and Assisted Suicide of Patients with Psychiatric Disorders in the Netherlands 2011–2014 > DISCUSSION
Strength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesIn the paper
“Applying some of these criteria to persons with terminal illness (cancer accounts for over 83% of reported EAS in the Netherlands22) arguably requires less judgment than in psychiatric cases since the eventual prognosis of the terminally ill is not in question.”
§ Euthanasia and Assisted Suicide of Patients with Psychiatric Disorders in the Netherlands 2011–2014 > DISCUSSION
What the sources say
- Not matchedcites [22]
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
Strength:hedged· not yet calibratedCausal:direct· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passes- Not matched
None of the sources cited for this claim could be matched to a paper in Crossref, so there is nothing to check it against.
In the paper
“the results may not generalize to other countries that allow euthanasia for mental disorders6 because reporting compliance rate and review procedures29,30 as well as availability of mental health services and insurance may be different than in the Netherlands.”
§ Euthanasia and Assisted Suicide of Patients with Psychiatric Disorders in the Netherlands 2011–2014 > DISCUSSION
What the sources say
- Not matchedcites [6]
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
- Not matchedcites [29]
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- Not matchedcites [30]
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
Strength:hedged· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passes- Not matched
In the paper
“although the RTE often cites the Dutch Psychiatric Association Guidelines, it accepts practices less strict than the Guidelines (but consistent with the RTE’s Code of Practice27).”
§ Euthanasia and Assisted Suicide of Patients with Psychiatric Disorders in the Netherlands 2011–2014 > DISCUSSION
What the sources say
- Not matchedcites [27]
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
Strength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passes- Not matched
In the paper
“Because of the Dutch system’s commitment to transparency, summaries of a majority of cases of psychiatric EAS are available online.7”
§ Euthanasia and Assisted Suicide of Patients with Psychiatric Disorders in the Netherlands 2011–2014 > Abstract > Conclusions and Relevance
What the sources say
- Not matchedcites [7]
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passes- Not matched
None of the sources cited for this claim could be matched to a paper in Crossref, so there is nothing to check it against.
In the paper
“Euthanasia and/or physician assisted suicide of psychiatric patients is increasing in some jurisdictions such as Belgium and the Netherlands.”
§ Euthanasia and Assisted Suicide of Patients with Psychiatric Disorders in the Netherlands 2011–2014 > Abstract > Importance
What the sources say
- Not matchedcites [6]
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
- Not matchedcites [7]
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
- Not matchedcites [8]
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
- Not matchedcites [9]
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passes- Not matched
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“It is possible that EAS makes the desire to die in women psychiatric patients more effective.”
§ Euthanasia and Assisted Suicide of Patients with Psychiatric Disorders in the Netherlands 2011–2014 > DISCUSSION
Strength:hedged· not yet calibratedCausal:conditional· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesIn the paper
“it appears the Belgian psychiatrist attracted younger psychiatric patients with fewer co-morbidities.”
§ Euthanasia and Assisted Suicide of Patients with Psychiatric Disorders in the Netherlands 2011–2014 > DISCUSSION
What the sources say
- Not matchedcites [13]
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
Strength:hedged· not yet calibratedCausal:direct· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passes- Not matched
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“Because the publication practice of the RTE changed during 2013–2014, the results cannot be generalized to the entire 2011–14 period”
§ Euthanasia and Assisted Suicide of Patients with Psychiatric Disorders in the Netherlands 2011–2014 > DISCUSSION
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passes
- It may state two separate claims as one. 19
- Probably not a substantial claim. 19
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“(There was one additional case involving the End-of-Life Clinic, for a total of 15 End-of-Life Clinic cases.)”
§ Euthanasia and Assisted Suicide of Patients with Psychiatric Disorders in the Netherlands 2011–2014 > RESULTS > EAS Refusal History and End-of-Life Clinic
Strength:plain· not yet calibratedn = 15Tests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesIt may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“12 patients (18%) had at least 3.”
§ Euthanasia and Assisted Suicide of Patients with Psychiatric Disorders in the Netherlands 2011–2014 > RESULTS > Characteristics of Patients
Strength:plain· not yet calibratedn = 12Tests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passesProbably not a substantial claim. The paper’s conclusions may not depend on it.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“There was one disagreement about the unbearable suffering criterion. The remaining disagreements were about competence (8 of 16) and futility (13 of 16; once case could have more than one).”
§ Euthanasia and Assisted Suicide of Patients with Psychiatric Disorders in the Netherlands 2011–2014 > RESULTS > Disagreement Among Physicians
Strength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesIt may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“In 3 cases, their physicians changed their minds; in the remaining 18, the physician performing the EAS was new to the patient.”
§ Euthanasia and Assisted Suicide of Patients with Psychiatric Disorders in the Netherlands 2011–2014 > RESULTS > EAS Refusal History and End-of-Life Clinic
Strength:plain· not yet calibratedn = 3Tests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesIt may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“in 6 patients (9·1%) approximately 6–10 years”
§ Euthanasia and Assisted Suicide of Patients with Psychiatric Disorders in the Netherlands 2011–2014 > RESULTS > Characteristics of Patients
Strength:plain· not yet calibratedn = 6Tests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passesProbably not a substantial claim. The paper’s conclusions may not depend on it.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“due to no motivation in 18 cases, concern about side effects or risk of harm in 12 cases, and doubts about efficacy in 10 cases”
§ Euthanasia and Assisted Suicide of Patients with Psychiatric Disorders in the Netherlands 2011–2014 > RESULTS > Treatment and Refusal
Strength:plain· not yet calibratedn = 18Tests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesIt may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The time from first meeting with the Clinic’s physician to death ranged from 3 weeks in one case (“due care not met” case), less than 3 months in 7 cases, and 5–12 months in 7 cases.”
§ Euthanasia and Assisted Suicide of Patients with Psychiatric Disorders in the Netherlands 2011–2014 > RESULTS > EAS Refusal History and End-of-Life Clinic
Strength:plain· not yet calibratedn = 7Tests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesIt may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The End-of-Life Clinic cases increased: 1 of 12 cases in 2012, 6 of 32 in 2013, and 8 of 16 in 2014.”
§ Euthanasia and Assisted Suicide of Patients with Psychiatric Disorders in the Netherlands 2011–2014 > RESULTS > EAS Refusal History and End-of-Life Clinic
Tests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesIt may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“24% were 30–50”
- Also stated in: § Characteristics of Patients · plain
“24% were 30–50 years old”
§ Euthanasia and Assisted Suicide of Patients with Psychiatric Disorders in the Netherlands 2011–2014 > Abstract > Results
Strength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passesProbably not a substantial claim. The paper’s conclusions may not depend on it.
- Also stated in: § Characteristics of Patients · plain
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The mean number of words (in Dutch, excluding abstracts) per report declined yearly from 2011 to 2014: 1573, 1248, 1154, 1117.”
§ Euthanasia and Assisted Suicide of Patients with Psychiatric Disorders in the Netherlands 2011–2014 > RESULTS > Review Committee Actions
Strength:plain· not yet calibratedCausal:correlational· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passesProbably not a substantial claim. The paper’s conclusions may not depend on it.
In the paper
“The RTE exercised case-specific flexibility. For example, although the RTE’s stated view is that the intervening time from EAS consultation to death should be less than a “few weeks,”7 a lag of 3 months without a revisit by a consultant in one case (due to a vacation) was, due to case-specific reasons, deemed acceptable.(2013-09)”
§ Euthanasia and Assisted Suicide of Patients with Psychiatric Disorders in the Netherlands 2011–2014 > RESULTS > Review Committee Actions
What the sources say
- Not matchedcites [7]
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
Strength:plain· not yet calibratedSingle caseTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesIt may state two separate claims as one.
- Not matched
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Four women had a chronic eating disorder with borderline personality disorder.”
§ Euthanasia and Assisted Suicide of Patients with Psychiatric Disorders in the Netherlands 2011–2014 > RESULTS > Characteristics of Patients
Strength:plain· not yet calibratedn = 4Tests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passesProbably not a substantial claim. The paper’s conclusions may not depend on it.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“in 5 of these cases, the EAS physician was not a psychiatrist; in 4 of these 5 cases, psychiatric input came from clinicians already involved in the patient’s care.”
§ Euthanasia and Assisted Suicide of Patients with Psychiatric Disorders in the Netherlands 2011–2014 > RESULTS > Consultations and Second Opinions
Strength:plain· not yet calibratedn = 5Tests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesIt may state two separate claims as one.
None of the sources cited for this claim could be matched to a paper in Crossref, so there is nothing to check it against.
In the paper
“one striking finding is that the women/men ratio is 2.3 which is the reverse of the women/men suicide ratio in the Netherlands20 and almost identical to the ratio of women/men suicide attempts.21”
§ Euthanasia and Assisted Suicide of Patients with Psychiatric Disorders in the Netherlands 2011–2014 > DISCUSSION
What the sources say
- Not matchedcites [20]
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
- Not matchedcites [21]
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesIt may state two separate claims as one.
- Not matched
In the paper
“Thus, the cases we studied were only somewhat younger than the Dutch EAS recipients overall and 60% are still over the age of 60.22”
§ Euthanasia and Assisted Suicide of Patients with Psychiatric Disorders in the Netherlands 2011–2014 > DISCUSSION
What the sources say
- Not matchedcites [22]
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
Strength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesIt may state two separate claims as one.
- Not matched
In the paper
“Only one of 110 psychiatric EAS cases did not meet due care criteria; in 2014, 4 of 5306 (0.1%) EAS cases were judged not to meet due care.18”
§ Euthanasia and Assisted Suicide of Patients with Psychiatric Disorders in the Netherlands 2011–2014 > DISCUSSION
What the sources say
- Not matchedcites [18]
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesIt may state two separate claims as one.
- Not matched
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“In 7 cases, the EAS performing physicians apparently felt the need to seek 3 official EAS consultations (the law requires one) and in a third of cases (22 of 66) there were 3 or more physicians (in various roles, not counting the EAS physician) involved in the evaluation.”
§ Euthanasia and Assisted Suicide of Patients with Psychiatric Disorders in the Netherlands 2011–2014 > DISCUSSION
Strength:hedged· not yet calibratedn = 7Tests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesIt may state two separate claims as one.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“the results still rely on coding judgments and approximations of quantities that are described imprecisely.”
§ Euthanasia and Assisted Suicide of Patients with Psychiatric Disorders in the Netherlands 2011–2014 > DISCUSSION
Strength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passesProbably not a substantial claim. The paper’s conclusions may not depend on it.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The variability of physician judgments may be reflected in almost a third of the patients having been refused EAS and a quarter of the cases engendering disagreements among involved physicians.”
§ Euthanasia and Assisted Suicide of Patients with Psychiatric Disorders in the Netherlands 2011–2014 > DISCUSSION
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesIt may state two separate claims as one.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“The coding scheme was developed iteratively by a bioethicist-psychiatrist (SK) and a consultation psychiatrist (JP) as they independently read the reports, repeatedly comparing variables of interest in light of the main research questions of the project. SK read and coded all of the reports and JP confirmed the coding by reading through the reports again; discrepancies were resolved by discussion.”
§ Euthanasia and Assisted Suicide of Patients with Psychiatric Disorders in the Netherlands 2011–2014 > METHODS
Strength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passesProbably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
In the paper
“The primary limitation of our study is that because the RTE reports are intentionally written in “plain language,”28 there is a limit to what can be inferred clinically.”
§ Euthanasia and Assisted Suicide of Patients with Psychiatric Disorders in the Netherlands 2011–2014 > DISCUSSION
What the sources say
- Not matchedcites [28]
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
Strength:plain· not yet calibratedCausal:direct· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passesProbably not a substantial claim. The paper’s conclusions may not depend on it.
- Not matched
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“Translations were obtained through the National Institutes of Health Library’s Translation Services which uses companies to provide certified medical translations.”
§ Euthanasia and Assisted Suicide of Patients with Psychiatric Disorders in the Netherlands 2011–2014 > METHODS
Strength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passesProbably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“We conclude that the practice of EAS for psychiatric disorders involves complicated, suffering patients whose requests for EAS often require considerable physician judgment.”
§ Euthanasia and Assisted Suicide of Patients with Psychiatric Disorders in the Netherlands 2011–2014 > DISCUSSION
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesIt may state two separate claims as one.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“Analysis consisted of frequencies and ad hoc cross-tabulations, without hypothesis testing given the descriptive goals of the study.”
§ Euthanasia and Assisted Suicide of Patients with Psychiatric Disorders in the Netherlands 2011–2014 > METHODS
Strength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passesProbably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“an important strength of our study is that we examined reports of actual psychiatric EAS cases across an entire jurisdiction, rather than asking physicians to recollect their experiences or opinions.”
§ Euthanasia and Assisted Suicide of Patients with Psychiatric Disorders in the Netherlands 2011–2014 > DISCUSSION
Load-bearingStrength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesProbably not a substantial claim.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“When consultants disagreed, the RTE gives deference to the opinion of the treating psychiatrists.”
§ Euthanasia and Assisted Suicide of Patients with Psychiatric Disorders in the Netherlands 2011–2014 > DISCUSSION
Strength:plain· not yet calibratedCausal:direct· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passesProbably not a substantial claim. The paper’s conclusions may not depend on it.
None of the sources cited for this claim could be matched to a paper in Crossref, so there is nothing to check it against.
In the paper
“For psychiatric cases, one might expect more variability in judgments, given the potential impact of some neuropsychiatric conditions on decision-making capacity15,23,24 and the more complicated determinations of medical futility that must incorporate patients’ treatment refusals in the context of less than certain prognosis even among persons with treatment resistant depression.25,26”
§ Euthanasia and Assisted Suicide of Patients with Psychiatric Disorders in the Netherlands 2011–2014 > DISCUSSION
What the sources say
- Not matchedcites [15]
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
- Not matchedcites [23]
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
- Not matchedcites [24]
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesProbably not a substantial claim.
- Not matched
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“However, little is known about the practice and it remains very controversial.”
§ Euthanasia and Assisted Suicide of Patients with Psychiatric Disorders in the Netherlands 2011–2014 > Abstract > Importance
Load-bearingStrength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✗ Based: failsProbably not a substantial claim. The paper may give no reason why it holds.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“Two senior psychiatrists used directed content analysis to review and code the reports.”
§ Euthanasia and Assisted Suicide of Patients with Psychiatric Disorders in the Netherlands 2011–2014 > Abstract > Design and Setting
Load-bearingStrength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesProbably not a substantial claim.
None of the sources cited for this claim could be matched to a paper in Crossref, so there is nothing to check it against.
In the paper
“Psychiatric disorders contribute to suicides (a major public health problem14), can sometimes impair decision-making,15 and are stigmatized.16”
§ Euthanasia and Assisted Suicide of Patients with Psychiatric Disorders in the Netherlands 2011–2014 > Abstract > Conclusions and Relevance
What the sources say
- Not matchedcites [14]
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
- Not matchedcites [15]
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
- Not matchedcites [16]
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesProbably not a substantial claim. It may state two separate claims as one.
- Not matched
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Dutch physicians, in spite of their open attitude toward EAS, may be self-regulating to limit EAS to such complex cases; or, it may be that psychiatric patients with those features may disproportionately seek EAS.”
§ Euthanasia and Assisted Suicide of Patients with Psychiatric Disorders in the Netherlands 2011–2014 > DISCUSSION
Strength:hedged· not yet calibratedCausal:conditional· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passesProbably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
In the paper
“Further, requests for EAS to relieve suffering from psychiatric conditions require special scrutiny.7”
§ Euthanasia and Assisted Suicide of Patients with Psychiatric Disorders in the Netherlands 2011–2014 > Abstract > Conclusions and Relevance
What the sources say
- Not matchedcites [7]
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
Load-bearingStrength:plain· not yet calibratedTests✓ Asserted: passes✗ Checkable: fails✓ Load-bearing: passes✓ Based: passesProbably not a substantial claim. It may be too vague to check against evidence.
- Not matched
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The retrospective oversight system in the Netherlands generally defers to the judgments of physicians who perform and report EAS.”
§ Euthanasia and Assisted Suicide of Patients with Psychiatric Disorders in the Netherlands 2011–2014 > DISCUSSION
Strength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✗ Based: failsProbably not a substantial claim. The paper’s conclusions may not depend on it. The paper may give no reason why it holds.
The paper relies on this without support.
The published RTE case summaries accurately and completely describe the psychiatric EAS cases.
“We reviewed all online reports identified by the Regional Euthanasia Review Committees (RTE) as psychiatric cases, available as of 1 June 2015.”
The paper relies on this without support.
The 66 published cases are representative of all psychiatric EAS cases in the Netherlands during 2011–14.
“66 cases from 2011–14 were reviewed.”
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
The cited source doesn’t support the claim as written.
In the citing paper
“This finding is in line with those of earlier studies reporting that 71%–79% of psychiatric patients who died through MAiD in the Netherlands had more than 1 psychiatric disorder. 4,17,19”
From Establishing irremediable psychiatric suffering in the context of medical assistance in dying in the Netherlands: a qualitative study (2022) · cites this paper as [19]
Checked by a reasoning model — may be wrong.
Experimental — accuracy not yet measuredThe cited source doesn’t support the claim as written.
In the citing paper
“Less than 20% suffer from schizophrenia and less than 10% each from anxiety disorders, trauma sequelae, addictive disorders, bipolar disorders or others.”
From Assisted suicide in persons with mental disorders: a review of clinical-ethical arguments and recommendations (2024) · cites this paper as [26]
Checked by a reasoning model — may be wrong.
Experimental — accuracy not yet measuredThe source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“about half of patients had made suicide attempts before [62, 63], including while waiting for approval [61].”
From Debating Euthanasia and Physician-Assisted Death in People with Psychiatric Disorders (2022) · cites this paper as [62]
Experimental — accuracy not yet measuredThe source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“for patients with mood or personality disorders, mainly women and aged between 50 and 70 years [62, 65].”
From Debating Euthanasia and Physician-Assisted Death in People with Psychiatric Disorders (2022) · cites this paper as [62]
Experimental — accuracy not yet measuredThe source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“Kim et al. (2016) and Van Veen et al. (2018) showed that these disorders are most common among patients suffering from a PD requesting EAS.”
From The Dutch practice of euthanasia and assisted suicide in patients suffering from psychiatric disorders: a qualitative case review study (2024) · cites this paper as [20]
Experimental — accuracy not yet measured
The source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“Previous studies also found an overrepresentation of females (70% and 77%)”
From The Dutch practice of euthanasia and assisted suicide in patients suffering from psychiatric disorders: a qualitative case review study (2024) · cites this paper as [20]
Experimental — accuracy not yet measuredThe source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“Empirical studies from the Netherlands show that there is disagreement about irremediability between psychiatrists in 11% to 20% of the PADs due to psychiatric suffering.8,51”
From Irremediable Psychiatric Suffering in the Context of Physician-assisted Death: A Scoping Review of Arguments: La souffrance psychiatrique irrémédiable dans le contexte du suicide assisté : Une revue étendue des arguments (2020) · cites this paper as [8]
Experimental — accuracy not yet measuredThe source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“Reasons for refusal were lacking motivation in 29% of all cases, concern about adverse effects or risks of harm in 18%, and doubts about efficacy in 15%.”
From Irremediable Psychiatric Suffering in the Context of Physician-assisted Death: A Scoping Review of Arguments: La souffrance psychiatrique irrémédiable dans le contexte du suicide assisté : Une revue étendue des arguments (2020) · cites this paper as [8]
Experimental — accuracy not yet measuredThe source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“Samples from the Netherlands and Belgium show the following picture for patients with psychiatric disorders (without dementia), combined for assisted suicide and euthanasia: more than half of the patients are female”
From Assisted suicide in persons with mental disorders: a review of clinical-ethical arguments and recommendations (2024) · cites this paper as [26]
Experimental — accuracy not yet measuredThe source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“about half of them suffer from depression and the other half from personality disorders.”
From Assisted suicide in persons with mental disorders: a review of clinical-ethical arguments and recommendations (2024) · cites this paper as [26]
Experimental — accuracy not yet measuredThe source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“Comorbidities are common (25-27).”
From Assisted suicide in persons with mental disorders: a review of clinical-ethical arguments and recommendations (2024) · cites this paper as [26]
Experimental — accuracy not yet measuredThe source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“in the few European countries that provide euthanasia for mental illness, the majority of those requesting it are women and marginalized individuals disproportionately seeking relief from suffering, not from their mental illnesses per se, but because of marginalization, including unresolved social and economic suffering and loneliness”
From The realities of Medical Assistance in Dying in Canada (2023) · cites this paper as Kim et al. 2016
Experimental — accuracy not yet measuredThe cited source says what the claim attributes to it.
In the citing paper
“More recently, in a 2016 study of 66 case summaries of Dutch patients who received PAD due to psychiatric suffering between 2011 and 2014, it was found that 56% of the patients had refused at least 1 treatment, ranging from psychotherapy to medication or ECT.”
The cited source says what the claim attributes to it.
In the citing paper
“It was also reported that personality disorders play a common role in treatment refusal.8”
The cited source says what the claim attributes to it.
In the citing paper
“The finding that treatment refusal is a relevant issue is in line with results from an earlier study showing that 56% of patients with a psychiatric disorder who received MAiD refused some form of treatment.19”
From Establishing irremediable psychiatric suffering in the context of medical assistance in dying in the Netherlands: a qualitative study (2022) · cites this paper as [19]
The cited source says what the claim attributes to it.
In the citing paper
“cases have been documented in the United States (2), the Netherlands (6–10), and Belgium (11–13).”
From Assisted death in eating disorders: a systematic review of cases and clinical rationales (2024) · cites this paper as [8]
The cited source says what the claim attributes to it.
In the citing paper
“In an analysis of 66 patients who received MAiD for mental disorders in the Netherlands between 2011 and 2014, depression was the most common disorder (55%), but most patients also had also been diagnosed with one or more additional psychiatric disorders, such as personality disorders, psychotic disorders, post-traumatic stress, anxiety, somatoform/eating disorders, prolonged grief and autism.”
From Medical Assistance in Dying for the Sole Underlying Condition of Mental Disorder (MAiD MD-SUMC): an analysis and qualitative evidence synthesis (2026) · cites this paper as [60]
The cited source says what the claim attributes to it.
In the citing paper
“The finding that treatment refusal is a relevant issue is in line with results from an earlier study showing that 56% of patients with a psychiatric disorder who received MAiD refused some form of treatment.19”
From Establishing irremediable psychiatric suffering in the context of medical assistance in dying in the Netherlands: a qualitative study (2022) · cites this paper as [19]
The cited source says what the claim attributes to it.
In the citing paper
“A study by Kim et al. reported a somewhat higher prevalence of somatic comorbidity amongst psychiatric patients who received EAS (60%) compared to our findings [12].”
The cited source says what the claim attributes to it.
In the citing paper
“However, the numbers of EAS in psychiatric practice are low and our findings are largely consistent with existing evidence [10–14].”
The cited source says what the claim attributes to it.
In the citing paper
“In most of the qualitative studies (Doernberg et al., 2016;Kim et al., 2016;Miller and Kim, 2017) data collection could not be evaluated because studies were performed using already available data (Table 4).”
From Euthanasia and assisted suicide in psychiatric patients: A systematic review of the literature (2021) · cites this paper as Kim et al., 2016
The cited source says what the claim attributes to it.
In the citing paper
“Women were preponderant in both pEAS-C and pEAS-R (Dierickx et al., 2017;Groenewoud et al., 1997;Kim et al., 2016;Nicolini et al., 2019;Thienpont et al., 2015a;van Veen et al., 2018).”
From Euthanasia and assisted suicide in psychiatric patients: A systematic review of the literature (2021) · cites this paper as Kim et al., 2016
The check wasn’t confident either way, so it gives no verdict — never disputed.
In the citing paper
“Therefore, it is less likely that the low response rate has compromised the validity of our findings.”
From Euthanasia and physician-assisted suicide in patients suffering from psychiatric disorders: a cross-sectional study exploring the experiences of Dutch psychiatrists (2019) · cites this paper as [12]
Experimental — accuracy not yet measuredIn the citing paper
“they all have some form of mental illness; most also have personality disorders, have attempted suicide, and are socially isolated or lonely.5”
From Suicide and Physician-Assisted Death for Persons With Psychiatric Disorders: How Much Overlap? (2018) · cites this paper as [5]
In the citing paper
“While in theory a patient and the physician together must agree that there is “no prospect of improvement,”5 the criterion is now overstretched to emphasize the subjective component, according to psychiatrists interviewed in a Dutch government study.6”
From Suicide and Physician-Assisted Death for Persons With Psychiatric Disorders: How Much Overlap? (2018) · cites this paper as [5]
In the citing paper
“This view is consistent with evidence showing that most patients receiving psychiatric PAD refuse available treatments (such as electroconvulsive therapy or monoamine oxidase inhibitors for depression) but are still deemed to meet the futility criterion.5”
From Suicide and Physician-Assisted Death for Persons With Psychiatric Disorders: How Much Overlap? (2018) · cites this paper as [5]
In the citing paper
“Indeed, some receive PAD shortly after a suicide attempt, like a man who jumped off a building, survived the fall with broken thighs, and then received PAD during the ensuing hospitalization.5”
From Suicide and Physician-Assisted Death for Persons With Psychiatric Disorders: How Much Overlap? (2018) · cites this paper as [5]
In the citing paper
“Therefore, the time frame covered by the present study represents the period during which the summaries of most psychiatric EAS cases were published.5”
From “Nothing Hurts Less Than Being Dead”: Psychological Pain in Case Descriptions of Psychiatric Euthanasia and Assisted Suicide from the Netherlands: « Rien ne fait moins mal qu’être mort »: La douleur psychologique dans les descriptions de cas d’euthanasie et de suicide assisté psychiatrique aux Pays-Bas (2020) · cites this paper as [5]
In the citing paper
“Both studies found that most patients were diagnosed with multiple psychiatric disorders (71–79%). Common diagnoses were depression (46–74%), personality disorders and personality problems (52–54%), anxiety disorders (11–23%), and PTSD (20–23%).”
From Physician Assisted Death for Psychiatric Suffering: Experiences in the Netherlands (2022) · cites this paper as [11]
In the citing paper
“Thirdly, there is disagreement about whether patients who refuse certain treatments can be said to suffer irremediably. This is not a mere theoretical discussion: a casefile study shows that 56% of Dutch patients who received PAD due to psychiatric suffering did refuse some sort of treatment (11).”
From Physician Assisted Death for Psychiatric Suffering: Experiences in the Netherlands (2022) · cites this paper as [11]
In the citing paper
“First, research shows, that many patients requesting PAD suffer from long lasting and complex psychiatric disorders (10–12). This chronicity, may make it more challenging to assess if the death wish is unduly influenced by the psychiatric disorder (25).”
From Physician Assisted Death for Psychiatric Suffering: Experiences in the Netherlands (2022) · cites this paper as [11]
In the citing paper
“Studies of Dutch casefile summaries show that all patients who received PAD on the basis of psychiatric suffering were ultimately considered capable of making an informed decision (11, 12). One study showed that in 8% of the cases the doctors involved had differences of opinion about patient decision-making capacity, but in another study no cases of divergent views were found.”
From Physician Assisted Death for Psychiatric Suffering: Experiences in the Netherlands (2022) · cites this paper as [11]
In the citing paper
“In the study by Kim et al. [10] depressive disorders (55%), posttraumatic stress disorder and other anxiety disorders (42%) were prominent whereas 52% of the patients had personality-related problems, sometimes without a formal PD diagnosis, more so in younger patients. Social isolation or loneliness were mentioned in 56% of the cases.”
From Euthanasia and assisted suicide in patients with personality disorders: a review of current practice and challenges (2020) · cites this paper as [10]
In the citing paper
“The prevalence of PD was higher in patients who were younger.”
From Euthanasia and assisted suicide in patients with personality disorders: a review of current practice and challenges (2020) · cites this paper as [10]
In the citing paper
“Kim and co-workers reviewed the first 66 psychiatric cases of EAS published and found that 52% of these were patients with personality disorders or difficulties [10].”
From Euthanasia and assisted suicide in patients with personality disorders: a review of current practice and challenges (2020) · cites this paper as [10]
In the citing paper
“case reviews in the Netherlands suggest that in some of the reported cases of euthanasia on patients suffering from a psychiatric disorder some of the due care criteria may have been evaluated suboptimally (Doernberg, Peteet, & Kim, 2016;Kim, De Vries, & Peteet, 2016).”
From Psychiatric patients requesting euthanasia: Guidelines for sound clinical and ethical decision making (2019) · cites this paper as Kim, De Vries, & Peteet, 2016
In the citing paper
“Retrospective casefile studies of Dutch PPD who died through MAID show if experts disagree on a criterion, it often concerns irremediability.1,4”
From Irremediable psychiatric suffering in the context of medical assistance in dying: A delphi-study (2022) · cites this paper as [1]
In the citing paper
“For this request to be granted, most of these jurisdictions demand that the patient is competent in her request and has a medical condition that causes irremediable and unbearable suffering.1,2”
From Irremediable psychiatric suffering in the context of medical assistance in dying: A delphi-study (2022) · cites this paper as [1]
In the citing paper
“Although psychiatric MAID is relatively uncommon, its use appears to be rising in Belgium and the Netherlands and for a diverse range of disorders and emotional states, including personality disorders and loneliness (2, 3).”
From Medical Assistance in Dying: Challenges for Psychiatry (2018) · cites this paper as [2]
In the citing paper
“Consequently, although the reinforcement of feelings of hopelessness may not have a direct effect upon the progression of an advanced, somatic condition, it may nevertheless have a profound effect upon the severity of a person's suffering [16].”
From Is the exclusion of psychiatric patients from access to physician-assisted suicide discriminatory? (2019) · cites this paper as [16]
In the citing paper
“Other research has been based on second-hand accounts (e.g., psychiatrists) (Verhofstadt et al., 2020a(Verhofstadt et al., , 2020b;;Evenblij et al., 2019;Bolt et al., 2015) or case analyses (Kim et al., 2016), which likely do not fully capture the patients' life history.”
From Why adults with psychiatric conditions request euthanasia: A qualitative interview study of life experiences, motives and preventive factors (2021) · cites this paper as Kim et al., 2016
In the citing paper
“In addition, almost three out of four Belgian psychiatrists question the adequacy of euthanasia assessment in current practice, which is in line with previous Dutch studies that indicate dissension among physicians regarding whether the legal criteria were/can be met.16–18”
From Euthanasia in adults with psychiatric conditions: A descriptive study of the experiences of Belgian psychiatrists (2021) · cites this paper as [18]
In the citing paper
“For example, in the Netherlands from 2011 to 2014, a total of 110 psychiatric patients were reported to have received MAID, of whom only 4 women (3% of series) had eating disorders with borderline personality disorder [17].”
In the citing paper
“we must also consider the significant gender skew and psychiatric diagnoses within the use of EAS in some countries (i.e., eating disorders, personality disorders, trauma, autism) [71–73].”
From A lived experience response to the proposed diagnosis of terminal anorexia nervosa: learning from iatrogenic harm, ambivalence and enduring hope (2023) · cites this paper as [73]
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
Each contradiction between two passages listed here was confirmed by an independent check.
End-of-Life Clinic count conflates new physicians with all Clinic cases
MinorThe abstract says 15 of the 18 patients treated by a new physician were treated by End-of-Life Clinic physicians. The results say only 14 new physicians were affiliated with the Clinic; the fifteenth Clinic case was additional to those 14.
“18 (27%) patients received the procedure from physicians new to them, 15 (23%) of whom were physicians from the End-of-Life Clinic, a mobile euthanasia clinic.”
“In 14 cases, the new physician was affiliated with the End-of-Life Clinic.(Table 1) (There was one additional case involving the End-of-Life Clinic, for a total of 15 End-of-Life Clinic cases.)”
Percentage of cases without a psychiatrist consultant is miscalculated
MinorTwenty-nine of 66 cases is about 44%, not 41%.
Reported 41 · recomputed 43.939394
“In 41% (29 of 66) of cases, there were no official EAS consultants who were psychiatrists”
Citations
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2 of the 26 references couldn’t be matched to a known paper.
Cited by
Sorted by citations
Emanuel, E. J., Onwuteaka-Philipsen, B. D., Urwin, J. W., & Cohen, J. (2016) · JAMA · doi:10.1001/jama.2016.8499 · Cited by 751
Sulmasy, L. S., & Mueller, P. S. (2017) · Annals of Internal Medicine · doi:10.7326/m17-0938 · Cited by 147
“…study found that persons receiving euthanasia or physician-assisted suicide in the Netherlands for psychiatric disorders were mostly women with complex and chronic psychiatric, medical, and psychosocial histories, and disagreement about patient eligibility among physicians was not unusual (58, 59).”
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Metadata
- Authors
- Kim, S. Y. H., De Vries, R. G., & Peteet, J. R.
- Affiliations
- National Institutes of Health (US)
- Center for Bioethics and Social Sciences in Medicine, University of Michigan Medical School, Ann Arbor3CAPHRI School for Public Health and Primary Care, Maastricht University, Maastricht, the Netherlands
- Brigham and Women's Hospital (US)
- Corresponding author
- Kim, Scott Y. H.
- Venue
- JAMA Psychiatry
- Publisher
- American Medical Association (AMA)
- Published
- 2016-04-01
- Volume
- 73
- Issue
- 4
- Pages
- 362
- ISSN
- 2168-622X (ISSN-L)
- PMC
- PMC5530592
- OpenAlex
- W2271580562
- Semantic Scholar
- 1de22ff361bb9da8d2ca41414c7dc5a0f3247631
- Cited by
- 320
- References
- 26
- Citations by year
- 2026: 16 · 2025: 25 · 2024: 14 · 2023: 32 · 2022: 25 · 2021: 22 · 2020: 45 · 2019: 25 · 2018: 60 · 2017: 40 · 2016: 14
- FWCI
- 61.95
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- JAMA Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Research Publications (Maastricht University) (submittedVersion, other-oa)
- Funders
- U.S. Department of Health and Human Services
- University of Rochester
- National Institutes of Health (Z99CL999999)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Suicide and Self-Harm Studies
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Palliative Care and End-of-Life Issues
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Palliative and Oncologic Care
- Keywords
- euthanasia, assisted suicide, mental illness, euthanasia legislation, depressive disorders, personality disorders, social isolation, loneliness, physician consultation, end-of-life care, Netherlands, case characteristics, physician disagreement, psychiatric hospitalization, suicide attempts, comorbidities, functional disability, prolonged grief disorder
- MeSH terms
- Adult, Aged, Mental Disorders, Chronic Disease, Decision Making, Major Depressive Disorder, Euthanasia, Female, Humans, Male, Middle Aged, Netherlands, Physicians, Referral and Consultation, Retrospective Studies, Social Isolation, Somatoform Disorders, Stress Disorders, Post-Traumatic, Suicide, Attempted, Treatment Refusal, Mental Competency, Suicide, Assisted, Medical Futility, Government Regulation, Standard of Care
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