Physician Aid-in-Dying and Suicide Prevention in Psychiatry: A Moral Crisis?
Abstract
Involuntary psychiatric commitment for suicide prevention and physician aid-in-dying (PAD) in terminal illness combine to create a moral dilemma. If PAD in terminal illness is permissible, it should also be permissible for some who suffer from nonterminal psychiatric illness: suffering provides much of the justification for PAD, and the suffering in mental illness can be as severe as in physical illness. But involuntary psychiatric commitment to prevent suicide suggests that the suffering of persons with mental illness does not justify ending their own lives, ruling out PAD. Since both practices have compelling underlying justifications, the most reasonable accommodation might seem to be to allow PAD for persons with mental illness whose suffering is severe enough to justify self-killing, but prohibit PAD for persons whose suffering is less severe. This compromise, however, would require the articulation of standards by which persons' mental as well as physical suffering could be evaluated. Doing so would present a serious philosophical challenge.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
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 main concern surrounding MAiD-MD and suicide prevention is the idea that MAiD-MD is a way of helping some people commit suicide.
“The main concern surrounding MAiD-MD and suicide prevention is the idea that MAiD-MD is a way of helping some people commit suicide [49, 52].”
From Medical assistance in dying for people living with mental disorders: a qualitative thematic review (2023) · cites this paper as [49]
Cites
The Long-term Natural History of the Weekly Symptomatic Status of Bipolar I Disorder
Judd, L. L., Akiskal, H. S., Schettler, P. J., Endicott, J., Maser, J., Solomon, D. A., Leon, A. C., Rice, J. A., & Keller, M. B. (2002) · Archives of General Psychiatry · doi:10.1001/archpsyc.59.6.530 · Cited by 2,106 · 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 · see citing works
Dees, M., Vernooij‐Dassen, M., Dekkers, W., & van Weel, C. (2010) · Psycho-Oncology · doi:10.1002/pon.1612 · Cited by 125 · see citing works
May, A. M., & Klonsky, E. D. (2013) · Suicide and Life-Threatening Behavior · doi:10.1111/sltb.12037 · Cited by 101 · see citing works
Dunn, L. B., Palmer, B. W., Appelbaum, P. S., Saks, E. R., Aarons, G. A., & Jeste, D. V. (2007) · Schizophrenia Research · doi:10.1016/j.schres.2006.08.005 · Cited by 54 · see citing works
den Hartogh, G. (2016) · Bioethics · doi:10.1111/bioe.12287 · Cited by 23 · see citing works
Flagged first, then by citations
Cited by
Sorted by citations
Verhofstadt, M., Pardon, K., Audenaert, K., Deliens, L., Mortier, F., Liégeois, A., & Chambaere, K. (2021) · Journal of Psychiatric Research · doi:10.1016/j.jpsychires.2021.09.032 · Cited by 32 · see citing works
Nicolini, M. E., Gastmans, C., & Kim, S. Y. H. (2019) · The American Journal of Bioethics · doi:10.1080/15265161.2019.1659606 · Cited by 10 · see citing works
Medical assistance in dying for people living with mental disorders: a qualitative thematic review
Favron-Godbout, C., & Racine, E. (2023) · BMC Medical Ethics · doi:10.1186/s12910-023-00971-4 · Cited by 6 · see citing works
“Attempting to objectively assess suffering can also lead to insensitivity towards a person’s unique experiences of states they consider intolerable [49].”
BackgroundLemmens, T. (2019) · The American Journal of Bioethics · doi:10.1080/15265161.2019.1654026 · Cited by 5 · see citing works
- Authors
- Kious, B. M., & Battin, M. (.
- Affiliations
- University of Utah (US)
- University of Utah
- Corresponding author
- Kious, Brent M.
- ORCID
- Kious, Brent M.
- Venue
- The American Journal of Bioethics
- Publisher
- Informa UK Limited
- Published
- 2019-09-26
- Volume
- 19
- Issue
- 10
- Pages
- 29-39
- ISSN
- 1526-5161 (ISSN-L)
- 1536-0075
- OpenAlex
- W2976079387
- Cited by
- 54
- References
- 6
- Citations by year
- 2026: 3 · 2025: 5 · 2024: 7 · 2023: 7 · 2022: 7 · 2021: 7 · 2020: 3 · 2019: 15
- FWCI
- 7.37
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- The American Journal of Bioethics (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Ethics and bioethics in healthcare
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Palliative and Oncologic Care
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Palliative Care and End-of-Life Issues
- Keywords
- suicide prevention, involuntary psychiatric commitment, terminal illness, mental illness, moral permissibility, suffering, suicide, euthanasia, ethical dilemmas
- MeSH terms
- Suicide Prevention, Female, Humans, Male, Morals, Pain, Psychiatry, Stress, Psychological, Mental Competency, Suicide, Assisted, Terminally Ill, Persons with Psychiatric Disorders, Mentally Ill Persons
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
