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Cited by 44Ethics and bioethics in healthcareHealth, Medicine and SocietyPalliative and Oncologic Care

Are Concerns About Irremediableness, Vulnerability, or Competence Sufficient to Justify Excluding All Psychiatric Patients from Medical Aid in Dying?

Open access
Rooney, William, Schuklenk, Udo, van de Vathorst, Suzanne·2018·Health Care Analysis
DOI 10.1007/s10728-017-0344-8
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Abstract

Some jurisdictions that have decriminalized assisted dying (like Canada) exclude psychiatric patients on the grounds that their condition cannot be determined to be irremediable, that they are vulnerable and in need of protection, or that they cannot be determined to be competent. We review each of these claims and find that none have been sufficiently well-supported to justify the differential treatment psychiatric patients experience with respect to assisted dying. We find bans on psychiatric patients' access to this service amount to arbitrary discrimination. Proponents of banning the practice ignore or overlook alternatives to their proposal, like an assisted dying regime with additional safeguards. Some authors have further criticized assisted dying for psychiatric patients by highlighting allegedly problematic practices in those countries which allow it. We address recent evidence from the Netherlands, showing that these problems are either misrepresented or have straightforward solutions. Even if one finds such evidence troubling despite our analysis, other jurisdictions need not adopt every feature of the Dutch system.

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Crossref · 10.1007/s10728-017-0344-8

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28 of 28 references verified0 citation errors · 0 not checkable

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  • Invoking the construct of TRD is not a good starting point for identifying an irremediable psychiatric condition.

    “This further shows that, in professional debates about irremediability, invoking the construct of TRD is not ‘a good starting point for identifying an irremediable psychiatric condition’ (Rooney et al., 2018).”

    From Irremediability in psychiatric euthanasia: examining the objective standard (2023) · cites this paper as Rooney et al., 2018

  • Our findings do not support the claim that clinicians can rely on existing statistical and staging tools like the Maudsley Staging Method to predict chances of recovery in a person requesting psychiatric EAS.

    “Second, our findings do not support the claim, made by some, that clinicians can rely on existing statistical and staging tools like the Maudsley Staging Method to predict chances of recovery in a person requesting psychiatric EAS (Provencher-Renaud, Larivée, & Sénéchal, 2019; Rooney et al., 2018; Tanner, 2018).”

    From Irremediability in psychiatric euthanasia: examining the objective standard (2023) · cites this paper as Rooney et al., 2018

  • The need to protect people living with mental disorders is highlighted, given their possible vulnerability.

    “On the one hand, the need to protect people living with mental disorders is highlighted, given their possible vulnerability [15–17].”

    From Medical assistance in dying for people living with mental disorders: a qualitative thematic review (2023) · cites this paper as [16]

  • Among the unmet needs of people living with mental disorders are care and services needs (notably lack of symptom relief), daily needs (notably satisfying relationships), and existential needs (especially difficulty finding meaning in life).

    “Among the unmet needs of people living with mental disorders are those related to care and services (notably a lack of symptom relief), but also those related to daily needs (notably the need to have satisfying relationships) and existential needs (especially the difficulty of finding meaning to life) [16, 20, 68].”

    From Medical assistance in dying for people living with mental disorders: a qualitative thematic review (2023) · cites this paper as [16]

  • The practice of euthanasia in adults with psychiatric conditions remains subject to controversy, fiercely dividing clinical and ethical opinions, and sometimes resulting in legal examination.

    “As some contest whether and when an APC can meet all legal requirements, the practice remains subject to controversy, fiercely dividing clinical and ethical opinions,2–7 and sometimes resulting in legal examination.8,9”

    From Euthanasia in adults with psychiatric conditions: A descriptive study of the experiences of Belgian psychiatrists (2021) · cites this paper as [7]

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Authors
Rooney, W., Schuklenk, U., & van de Vathorst, S.
Affiliations
Queen's University (CA)
Corresponding author
Rooney, William
ORCID
Rooney, William
Venue
Health Care Analysis
Publisher
Springer Science and Business Media LLC
Published
2017-06-17
Volume
26
Issue
4
Pages
326-343
ISSN
  • 1065-3058 (ISSN-L)
  • 1573-3394
DOI
10.1007/s10728-017-0344-8
OpenAlex
W2626050906
Cited by
44
References
28
Citations by year
2026: 5 · 2025: 3 · 2024: 4 · 2023: 4 · 2022: 5 · 2021: 9 · 2020: 8 · 2019: 3 · 2018: 3
FWCI
3.59
Type
journal article
Language
en
Open access
Licence
Locations
  • Health Care Analysis (publishedVersion)
  • PubMed (publishedVersion)
  • EUR Research Repository (Erasmus University Rotterdam) (publishedVersion)
  • Data Archiving and Networked Services (DANS) (submittedVersion)
  • EUR Research Repository (Erasmus University Rotterdam) (submittedVersion)
  • Pure Amsterdam UMC (submittedVersion, other-oa)
Topics
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Ethics and bioethics in healthcare
  • Health Sciences › Health Professions › General Health Professions › Health, Medicine and Society
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Palliative and Oncologic Care
Keywords
medical assistance in dying, assisted dying, psychiatric patients, vulnerability, competence, discrimination
MeSH terms
Independent Medical Evaluation, Major Depressive Disorder, Diagnostic Errors, Health Services Accessibility, Humans, Netherlands, Remission, Spontaneous, Mental Competency, Suicide, Assisted, Practice Guidelines as Topic, Persons with Psychiatric Disorders, Vulnerable Populations

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