Capacity evaluations of psychiatric patients requesting assisted death in The Netherlands
Open accessAbstract
Background Euthanasia or physician-assisted suicide (EAS) of psychiatric patients is legal in some countries but remains controversial.Objective This study examined a frequently raised concern about the practice: how physicians address the issue of decision-making capacity of persons requesting psychiatric EAS.Methods A review of psychiatric EAS case summaries published by the Dutch Regional Euthanasia Review Committees. Directed content analysis using a capacity-specific 4 abilities model (understanding of facts, applying those facts to self, weighing/reasoning, and evidencing choice) was used to code texts discussing capacity. A total of 66 cases from 2011-2014 were reviewed.Results In 55% (36 of 66) of cases, the capacity-specific discussion consisted of only global judgments of patients' capacity, even in patients with psychotic disorders. Further, 32% (21 of 66) of cases included evidentiary statements regarding capacity-specific abilities; only 5 cases (8%) mentioned all 4 abilities. Physicians frequently stated that psychosis or depression did or did not affect capacity but provided little explanation regarding their judgments. Physicians in 8 cases (12%) disagreed about capacity; even when no explanation was given for the disagreement, the review committees generally accepted the judgment of the physician performing EAS. In one case, the physicians noted that not all capacity-specific abilities were intact but deemed the patient capable.Conclusion Case summaries of psychiatric EAS in the Netherlands do not show that a high threshold of capacity is required for granting EAS. Although this may reflect limitations in documentation, it likely represents a practice that reflects the normative position of the review committees.
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Studies have shown physicians frequently disagree on the competency of psychiatric patients who request assisted death - inter-rater reliability of capacity judgments by clinicians without the aid of standardized assessments is low, and modest evidence suggests clinicians tend to overestimate capacity.
“Studies have shown physicians frequently disagree on the competency of psychiatric patients who request assisted death — inter-rater reliability of capacity judgments by clinicians without the aid of standardized assessments is low, and modest evidence suggests clinicians tend to overestimate capacity (6, 47–50).”
From Assisted death in eating disorders: a systematic review of cases and clinical rationales (2024) · cites this paper as [6]
Split into 2 atoms — 1 confirmed, 1 partially supported, 0 disputed, 0 misattributed, 0 unverifiable. Expand the claim to see per-atom verdicts.
Experimental — accuracy not yet measuredThe first reports of assisted death in patients with EDs in the peer-reviewed literature emerged from Belgium and the Netherlands.
“The first reports of assisted death in patients with EDs in the peer-reviewed literature emerged from Belgium and the Netherlands (6, 12).”
From Assisted death in eating disorders: a systematic review of cases and clinical rationales (2024) · cites this paper as [6]
The Results report that four of the 66 Dutch psychiatric assisted-death cases involved patients with severe eating disorders. The paper therefore supports the Netherlands portion, but it does not establish that these were among the first peer-reviewed reports or report eating-disorder cases from Belgium; its Belgian figures concern neuropsychiatric cases generally. (LLM, conf=0.84)
Experimental — accuracy not yet measuredThe assessment of decision-making capacity in mentally ill persons can be more difficult than in persons with somatic diseases.
“However, the assessment of the decision-making capacity in mentally ill persons can be more difficult than in persons with somatic diseases (30,31).”
From Assisted suicide in persons with mental disorders: a review of clinical-ethical arguments and recommendations (2024) · cites this paper as [31]
The Abstract conclusion and Discussion say that capacity evaluation in psychiatric assisted-death cases can be complex and challenging, particularly because some neuropsychiatric conditions increase the risk of incapacity. They do not compare the difficulty of these assessments with assessments of people with somatic diseases. Page numbers are unavailable in our copy. (LLM, conf=0.85)
Experimental — accuracy not yet measuredIn most qualitative studies, data collection could not be evaluated because studies were performed using already available data.
“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 Doernberg et al., 2016
The Methods section says this study analyzed 66 previously published case reports, supporting the claim that it used already available data. The Discussion notes that those summaries omit parts of the medical records, but the paper does not say that data collection could not be evaluated. It also cannot establish the claim about most qualitative studies. (LLM, conf=0.82)
Experimental — accuracy not yet measuredCases of assisted dying in patients with eating disorders have been documented in the United States, the Netherlands, and Belgium.
“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 [6]
Doernberg et al. identified four patients with EDs who were euthanized in the Netherlands between 2011 and 2014.
“Doernberg et al. (6) identified four patients with EDs who were euthanized in the Netherlands between 2011 and 2014.”
From Assisted death in eating disorders: a systematic review of cases and clinical rationales (2024) · cites this paper as [6]
Physicians do not use, and review committees do not require, a high threshold of decision-making capacity for requesting pEAS.
“Contrary to what might be expected, physicians do not use, and the review committees do not require, a high threshold of decision-making capacity for requesting (Doernberg et al., 2016;Tuffrey-Wijne et al., 2018).”
From Euthanasia and assisted suicide in psychiatric patients: A systematic review of the literature (2021) · cites this paper as Doernberg et al., 2016
Some researchers are concerned about the rigor of capacity assessments in the Netherlands, since many reports only contained a short statement about the patient possessing decision-making capacity, but lacked a description on how this was assessed.
“However, some researchers are concerned about the rigor of the capacity assessments in the Netherlands, since many reports only contained a short statement about the patient possessing decision-making capacity, but lacked a description on how this was assessed (28).”
From Physician Assisted Death for Psychiatric Suffering: Experiences in the Netherlands (2022) · cites this paper as [28]
Case reviews in the Netherlands suggest that in some reported cases of euthanasia on patients suffering from a psychiatric disorder some due care criteria may have been evaluated suboptimally.
“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 Doernberg, Peteet, & Kim, 2016
Almost three out of four Belgian psychiatrists question the adequacy of euthanasia assessment in current practice.
“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 [17]
Only one Dutch and one Belgian study have shown that the assessment of mental capacity differs among individual physicians, partly due to personal values and belief systems, and in some cases seems flawed, leading to dissensions among physicians on the evaluation outcome.
“To our knowledge, only one Dutch and one Belgian study on this topic have shown that the assessment of this criterion differs among individual physicians (i.e. to some extent due to their personal values and belief system), 32 and, in some cases, seems even flawed, which has led to dissensions among physicians on the evaluation outcome. 17”
From Euthanasia in adults with psychiatric conditions: A descriptive study of the experiences of Belgian psychiatrists (2021) · cites this paper as [17]
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Cites
Three Approaches to Qualitative Content Analysis
Hsieh, H.-F., & Shannon, S. E. (2005) · Qualitative Health Research · doi:10.1177/1049732305276687 · Cited by 44,601 · see citing works
Statistical Methods in Diagnostic Medicine
Zhou, X., Sun, J., Pennello, G. A., Obuchowski, N. A., & McClish, D. K. (2011) · Wiley series in probability and statistics · doi:10.1002/9780470906514 · Cited by 1,785 · see citing works
Deciding for others: the ethics of surrogate decision making
(1990) · Choice Reviews Online · doi:10.5860/choice.28-0985 · Cited by 1,134 · see citing works
Assessing Competence to Consent to Treatment: A Guide for Physicians and Other Health Professionals
Grisso, T., & Appelbaum, P. S. (1998) · DigitalGeorgetown (Georgetown University Library) · Cited by 572 · see citing works
Kim, S. Y. H., De Vries, R. G., & Peteet, J. R. (2016) · JAMA Psychiatry · doi:10.1001/jamapsychiatry.2015.2887 · Cited by 320 · cited 6× · see citing works
“This likely underestimates the diversity of physician judgments on capacity, given that 21 patients had been earlier refused EAS but later received it, usually from other physicians.(4) The descriptions of some of the complex cases of disagreement show why such disagreements might occur, especially given the relativel…”
BackgroundMethodInfluentialSelf-citationComparison of standards for assessing patients' capacities to make treatment decisions
Grisso, T., & Appelbaum, P. S. (1995) · American Journal of Psychiatry · doi:10.1176/ajp.152.7.1033 · Cited by 250 · see citing works
Statistical Methods in Diagnostic Medicine
Zhou, X., Sun, J., Pennello, G. A., Obuchowski, N. A., & McClish, D. K. (2003) · Wiley series in probability and statistics · doi:10.1002/9781394220243.fmatter · Cited by 197 · see citing works
Bolt, E. E., Snijdewind, M. C., Willems, D. L., van der Heide, A., & Onwuteaka-Philipsen, B. D. (2015) · Journal of Medical Ethics · doi:10.1136/medethics-2014-102150 · Cited by 178 · see citing works
Medical decision-making capacity in patients with mild cognitive impairment
Okonkwo, O. C., Griffith, H. R., Belue, K., Lanza, S., ZAMRINI, E. Y., Harrell, L. E., Brockington, J. C., Clark, D. G., Raman, R., & Marson, D. C. (2007) · Neurology · doi:10.1212/01.wnl.0000277639.90611.d9 · Cited by 167 · see citing works
Kouwenhoven, P. S., Raijmakers, N. J., van Delden, J. J., Rietjens, J. A., Schermer, M. H., van Thiel, G. J., Trappenburg, M. J., van de Vathorst, S., van der Vegt, B. J., Vezzoni, C., et al. (2013) · Palliative Medicine · doi:10.1177/0269216312448507 · Cited by 151 · see citing works
Competence to refuse treatment in anorexia nervosa
Tan, J., Hope, T., & Stewart, A. (2003) · International Journal of Law and Psychiatry · doi:10.1016/j.ijlp.2003.09.010 · Cited by 150 · see citing works
(2007) · Tilburg foreign law review · doi:10.1163/221125907x00524 · Cited by 126 · see citing works
Assessing Competence to Consent to Treatment: A Guide for Physicians and Other Health Professionals
Tucker, D. E. (1998) · Annals of Internal Medicine · doi:10.7326/0003-4819-129-7-199810010-00030 · Cited by 114 · see citing works
Physician-assisted death in psychiatric practice in The Netherlands
Groenewoud, J. H., van der Maas, P. J., van der Wal, G., Hengeveld, M. W., Tholen, A. J., Schudel, W. J., & van der Heide, A. (1997) · New England Journal of Medicine · doi:10.1056/nejm199706193362506 · Cited by 104 · see citing works
Decisional Capacity for Research Participation in Individuals with Mild Cognitive Impairment
Jefferson, A. L., Lambe, S. A., Moser, D. J., Byerly, L. K., Ozonoff, A., & Karlawish, J. H. (2008) · Journal of the American Geriatrics Society · doi:10.1111/j.1532-5415.2008.01752.x · Cited by 99 · see citing works
The ethics of informed consent in Alzheimer disease research
Kim, S. Y. H. (2011) · Nature Reviews Neurology · doi:10.1038/nrneurol.2011.76 · Cited by 79 · see citing works
Self-citationGutheil, T. G., & Bursztajn, H. J. (1986) · American Journal of Psychiatry · doi:10.1176/ajp.143.8.1020 · Cited by 77 · see citing works
Evaluation of Capacity to Consent to Treatment and Research
Kim, S. Y. H. (2009) · Oxford University Press eBooks · doi:10.1093/med/9780195322958.001.0001 · Cited by 77 · see citing works
Self-citationAssisted dying: law and practice around the world
Dyer, O., White, C., & García Rada, A. (2015) · BMJ · doi:10.1136/bmj.h4481 · Cited by 68 · see citing works
Should assisted dying for psychiatric disorders be legalized in Canada?
Kim, S. Y. H., & Lemmens, T. (2016) · Canadian Medical Association Journal · doi:10.1503/cmaj.160365 · Cited by 68 · see citing works
Self-citationPreservation of the Capacity to Appoint a Proxy Decision Maker
Kim, S. Y. H., Karlawish, J. H., Kim, H. M., Wall, I. F., Bozoki, A., & Appelbaum, P. S. (2011) · Archives of General Psychiatry · doi:10.1001/archgenpsychiatry.2010.191 · Cited by 64 · see citing works
Self-citationAssessment of Decision-Making Capacity: Views and Experiences of Consultation Psychiatrists
Seyfried, L. S., Ryan, K. A., & Kim, S. Y. H. (2012) · Psychosomatics · doi:10.1016/j.psym.2012.08.001 · Cited by 60 · see citing works
Self-citationCapacity of Persons With Mental Retardation to Consent to Participate in Randomized Clinical Trials
Fisher, C. B., Cea, C. D., Davidson, P. W., & Fried, A. L. (2006) · American Journal of Psychiatry · doi:10.1176/ajp.2006.163.10.1813 · Cited by 59 · see citing works
Powell, R. (2003) · Mental Retardation · doi:10.1352/0047-6765(2003)041 · Cited by 48 · see citing works
Do Clinicians Follow a Risk-Sensitive Model of Capacity-Determination? An Experimental Video Survey
Kim, S. Y. H., Caine, E. D., Swan, J. G., & Appelbaum, P. S. (2006) · Psychosomatics · doi:10.1176/appi.psy.47.4.325 · Cited by 44 · see citing works
Self-citationTemporal inabilities and decision-making capacity in depression
Owen, G. S., Freyenhagen, F., Hotopf, M. H., & Martin, W. (2013) · Phenomenology and the Cognitive Sciences · doi:10.1007/s11097-013-9327-x · Cited by 44 · see citing works
The Assessment of Competence to Make a Treatment Decision: An Empirical Approach
Bean, G., Nishisato, S., Rector, N. A., & Glancy, G. (1996) · The Canadian Journal of Psychiatry · doi:10.1177/070674379604100205 · Cited by 41 · see citing works
Mental capacity as a safeguard in assisted dying: clarity is needed
Price, A. C. (2015) · BMJ · doi:10.1136/bmj.h4461 · Cited by 39 · see citing works
der Weide, M. C. J., Onwuteaka-Philipsen, B. D., & van der Wal, G. (2006) · Health Policy · doi:10.1016/j.healthpol.2006.03.005 · Cited by 32 · see citing works
Gostin, L. O., & Roberts, A. E. (2016) · JAMA · doi:10.1001/jama.2015.16586 · Cited by 30 · see citing works
The Changing Legal Climate for Physician Aid in Dying
Orentlicher, D., Pope, T. M., & Rich, B. A. (2014) · JAMA · doi:10.1001/jama.2014.4117 · Cited by 18 · see citing works
Survey of forensic psychiatrists on evaluation and treatment of prisoners on death row.
Leong, G. B., Silva, J., Weinstock, R., & Ganzini, L. K. (2000) · PubMed · Cited by 13 · see citing works
Flagged first, then by citations
Research works printed but not linked: 3
- [6]Regional Euthanasia Review Committees Annual Report 2015 2016 The Hague
- [28]Regional Euthanasia Review Committees Annual report 2013 2014 The Hague
- [29]Regional Euthanasia Review Committees Code of Practice 2015 2015 The Hague
Cited by
Sorted by citations
Advance euthanasia directives: a controversial case and its ethical implications
Miller, D. G., Dresser, R., & Kim, S. Y. H. (2019) · Journal of Medical Ethics · doi:10.1136/medethics-2017-104644 · Cited by 141 · see citing works
Self-citationDierickx, S., Deliens, L., Cohen, J., & Chambaere, K. (2017) · BMC Psychiatry · doi:10.1186/s12888-017-1369-0 · Cited by 129 · see citing works
Tuffrey-Wijne, I., Curfs, L., Finlay, I., & Hollins, S. (2018) · BMC Medical Ethics · doi:10.1186/s12910-018-0257-6 · Cited by 97 · see citing works
Euthanasia and assisted suicide in psychiatric patients: A systematic review of the literature
Calati, R., Olié, E., Dassa, D., Gramaglia, C., Guillaume, S., Madeddu, F., & Courtet, P. (2021) · Journal of Psychiatric Research · doi:10.1016/j.jpsychires.2020.12.006 · Cited by 88 · see citing works
Nicolini, M. E., Kim, S. Y. H., Churchill, M. E., & Gastmans, C. (2020) · Psychological Medicine · doi:10.1017/s0033291720001543 · Cited by 77 · see citing works
Self-citationGalderisi, S., Appelbaum, P. S., Gill, N., Gooding, P., Herrman, H., Melillo, A., Myrick, K., Pathare, S., Savage, M., Szmukler, G., et al. (2024) · World Psychiatry · doi:10.1002/wps.21230 · Cited by 76 · see citing works
Miller, D. G., & Kim, S. Y. H. (2017) · BMJ Open · doi:10.1136/bmjopen-2017-017628 · Cited by 69 · see citing works
Self-citationVerhofstadt, M., Van Assche, K., Sterckx, S., Audenaert, K., & Chambaere, K. (2019) · International Journal of Law and Psychiatry · doi:10.1016/j.ijlp.2019.04.004 · Cited by 60 · see citing works
Nicolini, M. E., Peteet, J. R., Donovan, G. K., & Kim, S. Y. H. (2020) · Psychological Medicine · doi:10.1017/s0033291719000333 · Cited by 52 · see citing works
Self-citationPhysician-assisted suicide and psychiatric illness
Vandenberghe, J. (2018) · New England Journal of Medicine · doi:10.1056/nejmp1714496 · Cited by 50 · see citing works
Evenblij, K., Pasman, H. R. W., van der Heide, A., Hoekstra, T., & Onwuteaka-Philipsen, B. D. (2019) · BMC Medicine · doi:10.1186/s12916-019-1276-y · Cited by 48 · see citing works
Euthanasia, Ethics and Public Policy
Keown, J. (2018) · Cambridge University Press eBooks · doi:10.1017/9781107337909 · Cited by 45 · see citing works
Rooney, W., Schuklenk, U., & van de Vathorst, S. (2018) · Health Care Analysis · doi:10.1007/s10728-017-0344-8 · Cited by 44 · see citing works
A National Survey of Canadian Psychiatrists’ Attitudes toward Medical Assistance in Death
Rousseau, S., Turner, S., Chochinov, H. M., Enns, M. W., & Sareen, J. (2017) · The Canadian Journal of Psychiatry · doi:10.1177/0706743717711174 · Cited by 32 · see citing works
Physician Assisted Death for Psychiatric Suffering: Experiences in the Netherlands
van Veen, S., Widdershoven, G., Beekman, A., & Evans, N. (2022) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2022.895387 · Cited by 29 · see citing works
Binder, M. D., Loos, S., Sterckx, S., Thys, E., & Assche, K. V. (2022) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2022.933748 · Cited by 26 · see citing works
Suicide and Physician-Assisted Death for Persons With Psychiatric Disorders: How Much Overlap?
Kim, S. Y. H., Conwell, Y., & Caine, E. D. (2018) · JAMA Psychiatry · doi:10.1001/jamapsychiatry.2018.2065 · Cited by 25 · see citing works
Self-citationByrnes, E., Ross, A. I., & Murphy, M. F. (2022) · OMEGA - Journal of Death and Dying · doi:10.1177/00302228221116697 · Cited by 22 · see citing works
Pronk, R., Willems, D. L., & van de Vathorst, S. (2021) · Culture Medicine and Psychiatry · doi:10.1007/s11013-020-09686-2 · Cited by 21 · see citing works
Verhofstadt, M., Audenaert, K., Van den Broeck, K., Deliens, L., Mortier, F., Titeca, K., De Bacquer, D., & Chambaere, K. (2021) · Science Progress · doi:10.1177/00368504211029775 · Cited by 21 · see citing works
Medical Assistance in Dying: Challenges for Psychiatry
Jones, R. M., & Simpson, A. I. F. (2018) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2018.00678 · Cited by 18 · see citing works
Schweitser, F., Stuy, J., Distelmans, W., & Rigo, A. (2021) · Journal of Medical Ethics · doi:10.1136/medethics-2019-105690 · Cited by 16 · see citing works
Assisted death in eating disorders: a systematic review of cases and clinical rationales
Roff, C., & Cook-Cottone, C. (2024) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2024.1431771 · Cited by 16 · see citing works
Attitudes Toward Euthanasia for Patients Who Suffer From Physical or Mental Illness
Levin, K., Bradley, G. L., & Duffy, A. L. (2018) · OMEGA - Journal of Death and Dying · doi:10.1177/0030222818754667 · Cited by 15 · see citing works
Verhofstadt, M., Audenaert, K., Van den Broeck, K., Deliens, L., Mortier, F., Titeca, K., Pardon, K., De Bacquer, D., & Chambaere, K. (2020) · BMC Psychiatry · doi:10.1186/s12888-020-02792-w · Cited by 14 · see citing works
Marckmann, G., & Pollmächer, T. (2024) · Annals of Palliative Medicine · doi:10.21037/apm-23-472 · Cited by 14 · see citing works
Lengvenyte, A., Strumila, R., Courtet, P., Kim, S. Y. H., & Olié, E. (2020) · The Canadian Journal of Psychiatry · doi:10.1177/0706743720931237 · Cited by 13 · see citing works
Self-citationBerens, N., & Kim, S. Y. H. (2022) · American Journal of Geriatric Psychiatry · doi:10.1016/j.jagp.2022.07.003 · Cited by 13 · see citing works
Self-citationBahji, A., & Delva, N. (2022) · Journal of Medical Ethics · doi:10.1136/medethics-2020-107133 · Cited by 12 · see citing works
Canadian Medical Assistance in Dying and the Hegemony of Privilege
Kim, S. Y. H. (2023) · The American Journal of Bioethics · doi:10.1080/15265161.2023.2264096 · Cited by 11 · see citing works
Self-citationAbout the practice of psychiatric euthanasia: a commentary
Lopez-Castroman, J. (2017) · BMC Medicine · doi:10.1186/s12916-017-0896-3 · Cited by 9 · see citing works
Kim, S. Y., Mangino, D., & Nicolini, M. (2021) · Journal of Medical Ethics · doi:10.1136/medethics-2020-106091 · Cited by 10 · see citing works
Self-citationThe capacity to consent to treatment is altered in suicidal patients
Olié, E., Catanzaro, T., Malestroit, M., Guija, J. A., Giner, L., & Courtet, P. (2023) · Annals of General Psychiatry · doi:10.1186/s12991-023-00459-w · Cited by 9 · see citing works
Verhofstadt, M., Assche, K. V., Pardon, K., Gleydura, M., Titeca, K., & Chambaere, K. (2024) · International Journal of Law and Psychiatry · doi:10.1016/j.ijlp.2024.101961 · Cited by 12 · see citing works
Taylor, J. B., & Stern, T. A. (2017) · Psychosomatics · doi:10.1016/j.psym.2017.03.008 · Cited by 9 · see citing works
La pratique de l’euthanasie et du suicide assisté pour motif psychiatrique
Guérinet, L., & Tournier, M. (2021) · L Encéphale · doi:10.1016/j.encep.2020.10.002 · Cited by 8 · see citing works
¿Los pacientes psiquiátricos son más vulnerables ante la ley de la eutanasia española?
Alacreu‐Crespo, A., Giner, L., & Courtet, P. (2021) · Revista de Psiquiatría y Salud Mental · doi:10.1016/j.rpsm.2021.01.003 · Cited by 7 · see citing works
Broer, T. (2020) · Information · doi:10.3390/info11030170 · Cited by 6 · see citing works
Helinck, S., Verhofstadt, M., Chambaere, K., & Pardon, K. (2024) · Qualitative Health Research · doi:10.1177/10497323241237459 · Cited by 5 · see citing works
Physician‐assisted death for psychiatric disorders: ongoing reasons for concern
Appelbaum, P. S. (2024) · World Psychiatry · doi:10.1002/wps.21153 · Cited by 4 · see citing works
Macri, R., Wagner, F., & Stuckey, M. I. (2020) · Canadian Journal of Community Mental Health · doi:10.7870/cjcmh-2020-009 · Cited by 3 · see citing works
Waddell, M. M. (2020) · Journal of Disability & Religion · doi:10.1080/23312521.2019.1694463 · Cited by 3 · see citing works
Wishing you won’t be here: Medical assistance in dying for psychiatric patients
Waring, D. R. (2018) · Ethics Medicine and Public Health · doi:10.1016/j.jemep.2018.08.004 · Cited by 3 · see citing works
Notes on psychiatrist liability around the world regarding suicide
Saya, A., Albanesi, G., Cichetti, D., Molfetta, M. D., Guarino, Y., Niolu, C., & Siracusano, A. (2025) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2024.1466325 · Cited by 2 · see citing works
Gold, A. (2023) · Journal of Medical Ethics · doi:10.1136/jme-2022-108829 · Cited by 3 · see citing works
Capacity assessment for euthanasia in dementia: A qualitative study of 60 Dutch cases
van den Bosch, A., Marijnissen, R. M., Hanssen, D. J. C., & Voshaar, R. C. O. (2024) · Journal of the American Geriatrics Society · doi:10.1111/jgs.19218 · Cited by 2 · see citing works
Courtet, P., & Olié, E. (2021) · Oxford Textbook of Suicidology and Suicide Prevention · doi:10.1093/med/9780198834441.003.0018 · Cited by 1 · see citing works
Binder, M. D., Sterckx, S., & Assche, K. V. (2023) · The International Library of Bioethics · doi:10.1007/978-3-031-25315-7_11 · Cited by 1 · see citing works
Anliegen eines assistierten Suizids bei älteren Menschen mit depressiven Störungen
Christl, J., & Supprian, T. (2025) · Zeitschrift für Gerontologie und Geriatrie · doi:10.1007/s00391-024-02398-x · Cited by 1 · see citing works
Gulino, M., Martelli, M., Ricci, P., Marinelli, S., & Vergallo, G. M. (2025) · Ethics Medicine and Public Health · doi:10.1016/j.jemep.2025.101131 · Cited by 1 · see citing works
Palliative psychiatry and euthanasia in refractory obsessive–compulsive disorder: A case report
López-Rodríguez, S., Lakis-Granell, S., González‐Barboteo, J., Real, E., Bertolín, S., Menchón, J. M., Alonso, M. D. P., & Segalàs, C. (2026) · Revista de Psiquiatría y Salud Mental · doi:10.1016/j.sjpmh.2026.03.002 · Cited by 1 · see citing works
Exploring the legal, medical, and ethical controversy: obstacles to euthanasia legalization in China
Xie, Z., & Duan, Z. (2026) · Critical Public Health · doi:10.1080/09581596.2026.2671479 · Cited by 1 · see citing works
Psychiatric patients are more vulnerable to the Spanish euthanasia law?
Alacreu‐Crespo, A., Giner, L., & Courtet, P. (2021) · Revista de Psiquiatría y Salud Mental (English Edition) · doi:10.1016/j.rpsmen.2021.01.001 · Cited by 1 · see citing works
Keown, J. (2018) · Cambridge University Press eBooks · doi:10.1017/9781107337909.026 · Cited by 1 · see citing works
Keown, J. (2018) · Cambridge University Press eBooks · doi:10.1017/9781107337909.007 · Cited by 1 · see citing works
Links, P. S., Aslam, H. M., & Brodeur, J. (2024) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2024.1364621 · Cited by 1 · see citing works
Euthanasia and Assisted Suicide in Psychiatry: An Overview of the Field
Nicolini, M. (2025) · The International Library of Bioethics · doi:10.1007/978-94-024-2274-0_31 · Cited by 1 · see citing works
Physician Aid-in-Dying: Practical Considerations
Kumaravel, A. (2018) · American Journal of Psychiatry Residents Journal · doi:10.1176/appi.ajp-rj.2018.130802 · Cited by 1 · see citing works
The Euthanasia Act and the Code of Practice
Keown, J. (2018) · Cambridge University Press eBooks · doi:10.1017/9781107337909.017 · Cited by 1 · see citing works
Trouble psychiatrique, souffrance réfractaire et aide active à mourir
Vachon, J., Mercy, P., Gasser, M., & Aubry, R. (2022) · Éthique & Santé · doi:10.1016/j.etiqe.2022.04.003 · Cited by 1 · see citing works
Dierickx, S. (2018) · Ghent University Academic Bibliography (Ghent University) · Cited by 1 · see citing works
Chastang, F., Lorenceau, H., Omnès, C., Védrinne, J., & Walter, M. (2021) · Gérontologie et société · doi:10.3917/gs1.164.0117
Suizidales Verhalten aus anthropologischer Sicht
Valdés‐Stauber, J. (2017) · Nervenheilkunde · doi:10.1055/s-0038-1627011
Determination of Competency for High-Gravity Life-Death Decision-Making
Schultz, I. Z., Stewart, A., & Sepehry, A. A. (2019) · Psychological Injury and Law · doi:10.1007/s12207-019-09361-x
Euthanasia and Physician-Assisted Suicide
Keown, J. (2018) · Cambridge University Press eBooks · doi:10.1017/9781107337909.005
Intended versus Foreseen Life-Shortening
Keown, J. (2018) · Cambridge University Press eBooks · doi:10.1017/9781107337909.006
Keown, J. (2018) · Cambridge University Press eBooks · doi:10.1017/9781107337909.025
Keown, J. (2018) · Cambridge University Press eBooks · doi:10.1017/9781107337909.012
Controverses au sujet du suicide assisté chez les personnes atteintes de troubles psychiatriques
Courtet, P., & Olié, É. (2022) · Bulletin de l Académie Nationale de Médecine · doi:10.1016/j.banm.2022.04.005
Shah, A. (2023) · The Journal of Nervous and Mental Disease · doi:10.1097/nmd.0000000000001670
Keown, J. (2018) · Cambridge University Press eBooks · doi:10.1017/9781107337909.009
Belgium’s Lack of Effective Control
Keown, J. (2018) · Cambridge University Press eBooks · doi:10.1017/9781107337909.023
Foreword to the Second Edition
Keown, J. (2018) · Cambridge University Press eBooks · doi:10.1017/9781107337909.002
Keown, J. (2018) · Cambridge University Press eBooks · doi:10.1017/9781107337909.003
A Right to Physician-Assisted Suicide by Stopping Eating and Drinking?
Keown, J. (2018) · Cambridge University Press eBooks · doi:10.1017/9781107337909.020
Keown, J. (2018) · Cambridge University Press eBooks · doi:10.1017/9781107337909.030
Keown, J. (2018) · Cambridge University Press eBooks · doi:10.1017/9781107337909.013
Keown, J. (2018) · Cambridge University Press eBooks · doi:10.1017/9781107337909.027
Keown, J. (2018) · Cambridge University Press eBooks · doi:10.1017/9781107337909.029
Keown, J. (2018) · Cambridge University Press eBooks · doi:10.1017/9781107337909.001
Keown, J. (2018) · Cambridge University Press eBooks · doi:10.1017/9781107337909.011
Keown, J. (2018) · Cambridge University Press eBooks · doi:10.1017/9781107337909.010
Keown, J. (2018) · Cambridge University Press eBooks · doi:10.1017/9781107337909.024
Keown, J. (2018) · Cambridge University Press eBooks · doi:10.1017/9781107337909.008
Keown, J. (2018) · Cambridge University Press eBooks · doi:10.1017/9781107337909.022
Keown, J. (2018) · Cambridge University Press eBooks · doi:10.1017/9781107337909.018
Canada’s Euthanasia Legislation
Keown, J. (2018) · Cambridge University Press eBooks · doi:10.1017/9781107337909.028
Assisted Suicide for the Elderly with ‘Completed Lives’
Keown, J. (2018) · Cambridge University Press eBooks · doi:10.1017/9781107337909.021
Keown, J. (2018) · Cambridge University Press eBooks · doi:10.1017/9781107337909.019
Keown, J. (2018) · Cambridge University Press eBooks · doi:10.1017/9781107337909.014
Keown, J. (2018) · Cambridge University Press eBooks · doi:10.1017/9781107337909.031
Keown, J. (2018) · Cambridge University Press eBooks · doi:10.1017/9781107337909.016
Keown, J. (2018) · Cambridge University Press eBooks · doi:10.1017/9781107337909.032
Keown, J. (2018) · Cambridge University Press eBooks · doi:10.1017/9781107337909.004
Keown, J. (2018) · Cambridge University Press eBooks · doi:10.1017/9781107337909.015
van Dijk, N. M., de Jongh, W., Stärcke, P., Shaw, D., Bollen, J. A. M., & van Mook, W. (2024) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2024.1234741
Searight, H. R., Anderson, M., & Lamma, S. (2025) · Springer eBooks · doi:10.1007/978-3-031-38971-9_2060-1
Dell’Osso, L., Nardi, B., Pronestì, C., Giovannoni, F., Cremone, I. M., Bonelli, C., Pini, S., Fiorillo, A., Paolo, M. D., & Carpita, B. (2026) · International Journal of Social Psychiatry · doi:10.1177/00207640251407182
Euthanasia in persons with mental illness: Clinical, ethical, and societal challenges
Cardoner, N. (2026) · Revista de Psiquiatría y Salud Mental · doi:10.1016/j.sjpmh.2026.04.002
Last resort: the ethical obligation to offer ketamine in psychiatric euthanasia and assisted suicide
Zhang, J., & Sisti, D. A. (2026) · Journal of Medical Ethics · doi:10.1136/jme-2025-111672
- Authors
- Doernberg, S. N., Peteet, J. R., & Kim, S. Y. H.
- Affiliations
- National Institutes of Health (US)
- Brigham and Women's Hospital (US)
- Corresponding author
- Kim, Scott Y.H.
- Venue
- Psychosomatics
- Publisher
- Elsevier BV
- Published
- 2016-11
- Volume
- 57
- Issue
- 6
- Pages
- 556-565
- ISSN
- 0033-3182 (ISSN-L)
- PMC
- PMC5097685
- OpenAlex
- W2462974228
- Cited by
- 103
- References
- 32
- Citations by year
- 2026: 6 · 2025: 7 · 2024: 8 · 2023: 5 · 2022: 6 · 2021: 8 · 2020: 9 · 2019: 5 · 2018: 42 · 2017: 7
- FWCI
- 24.10
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Psychosomatics (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institutes of Health (Z99CL999999)
- NIH Clinical Center (ZIACL010539)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Healthcare Decision-Making and Restraints
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Ethics and bioethics in healthcare
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Palliative Care and End-of-Life Issues
- Keywords
- physician-assisted suicide, euthanasia, psychiatric patients, decision-making capacity, capacity assessment, psychosis, depression, Netherlands, physician disagreement
- MeSH terms
- Clinical Decision-Making, Adult, Aged, Aged, 80 and over, Mental Disorders, Euthanasia, Female, Humans, Male, Middle Aged, Netherlands, Physician-Patient Relations, Mental Competency, Suicide, Assisted
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