Public and physicians’ support for euthanasia in people suffering from psychiatric disorders: a cross-sectional survey study
Open accessAbstract
Background: Although euthanasia and assisted suicide (EAS) in people with psychiatric disorders is relatively rare, the increasing incidence of EAS requests has given rise to public and political debate. This study aimed to explore support of the public and physicians for euthanasia and assisted suicide in people with psychiatric disorders and examine factors associated with acceptance and conceivability of performing EAS in these patients. Methods: A survey was distributed amongst a random sample of Dutch 2641 citizens (response 75%) and 3000 physicians (response 52%). Acceptance and conceivability of performing EAS, demographics, health status and professional characteristics were measured. Multivariable logistic regression analyses were performed. Results: Of the general public 53% were of the opinion that people with psychiatric disorders should be eligible for EAS, 15% was opposed to this, and 32% remained neutral. Higher educational level, Dutch ethnicity, and higher urbanization level were associated with higher acceptability of EAS whilst a religious life stance and good health were associated with lower acceptability. The percentage of physicians who considered performing EAS in people with psychiatric disorders conceivable ranged between 20% amongst medical specialists and 47% amongst general practitioners. Having received EAS requests from psychiatric patients before was associated with considering performing EAS conceivable. Being female, religious, medical specialist, or psychiatrist were associated with lower conceivability. The majority (> 65%) of the psychiatrists were of the opinion that it is possible to establish whether a psychiatric patient’s suffering is unbearable and without prospect and whether the request is well-considered. Conclusion: The general public shows more support than opposition as to whether patients suffering from a psychiatric disorder should be eligible for EAS, even though one third of the respondents remained neutral. Physicians’ support depends on their specialization; 39% of psychiatrists considered performing EAS in psychiatric patients conceivable. The relatively low conceivability is possibly explained by psychiatric patients often not meeting the eligibility criteria.
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The prognosis of non-terminal conditions such as most mental illnesses is unpredictable.
“the unpredictability of prognosis of non-terminal conditions such as most mental illnesses”
From Debating Euthanasia and Physician-Assisted Death in People with Psychiatric Disorders (2022) · cites this paper as [22]
The Discussion states that the course and prognosis of psychiatric disorders are unpredictable. It does not extend that point to non-terminal conditions generally, so the broader wording is not supported by this passage. No page number is provided in our copy. (LLM, conf=0.83)
Experimental — accuracy not yet measuredHalf of psychiatrists agree that MAiD-NT is compatible with a psychiatric care relationship in which it is possible to establish whether the desire to die is entangled with a psychiatric disorder.
“Half of them agree that MAiD-NT is compatible with a psychiatric care relationship [43] in which it is possible to establish whether the desire to die is entangled with a psychiatric disorder [41].”
From Debating Euthanasia and Physician-Assisted Death in People with Psychiatric Disorders (2022) · cites this paper as [41]
The Results section reports that 64.2% of psychiatrists considered assistance with suicide compatible with a care-provider relationship—not half. It also reports that 65.4% thought it possible to establish whether a psychiatric patient’s wish to die is well-considered or a consequence of underlying pathology. (LLM, conf=0.87)
Experimental — accuracy not yet measuredIn the Netherlands, 20% of medical specialists endorsed MAiD-NT, and about half of general practitioners endorsed it (main reasons: responsibility, self-determination, compassion, fairness, and preventing suicide).
“In the Netherlands, 20% of medical specialists endorsed the practice, about half among general practitioners (main reasons: responsibility, self-determination, compassion, fairness, and preventing suicide) [27, 38].”
From Debating Euthanasia and Physician-Assisted Death in People with Psychiatric Disorders (2022) · cites this paper as [27]
The Abstract Results (page unavailable) report that 20% of medical specialists and 47% of general practitioners considered performing EAS for people with psychiatric disorders conceivable. That supports the approximate percentages, but ‘conceivable’ is not necessarily endorsement. The paper does not give the listed reasons—responsibility, self-determination, compassion, fairness, and preventing suicide—as the main reasons for those physicians’ views. (LLM, conf=0.88)
Experimental — accuracy not yet measuredGrassi et al identified substantial international differences in public support for MAiD MD-SUMC: a majority of Dutch respondents (53%) supported MAiD eligibility for psychiatric patients, while only one-third of respondents in the USA expressed similar support for individuals with mental disorders or physical disabilities.
“Grassi et al10 identified substantial international differences: while a majority of Dutch respondents (53%) supported MAiD eligibility for psychiatric patients, only one-third of respondents in the USA expressed similar support for individuals with mental disorders or physical disabilities.”
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 [51]
Split into 2 atoms — 0 confirmed, 2 partially supported, 0 disputed, 0 misattributed, 0 unverifiable. Expand the claim to see per-atom verdicts.
Experimental — accuracy not yet measuredIn the Netherlands, 53% of the general population supported the eligibility of psychiatric patients for MAiD-NT, with only 15% stating their opposition to this practice.
“For example, in the Netherlands, half of the respondents (53%) of the general population supported the eligibility of psychiatric patients for MAiD-NT, with only 15% stating their opposition to this practice [27].”
From Debating Euthanasia and Physician-Assisted Death in People with Psychiatric Disorders (2022) · cites this paper as [27]
In the cited Dutch study, about 2/3 of psychiatrists believed it is possible to establish whether a psychiatric patient's suffering is unbearable.
“However, in the cited Dutch study [41, 42], about 2/3 of the psychiatrists believed it is possible to establish whether a psychiatric patient’s suffering is unbearable.”
From Debating Euthanasia and Physician-Assisted Death in People with Psychiatric Disorders (2022) · cites this paper as [41]
There is an ethical distinction between helping a dying person die peacefully and providing death to a non-dying person.
“the ethical distinction between helping a dying person die peacefully versus providing death to a non-dying person”
From Debating Euthanasia and Physician-Assisted Death in People with Psychiatric Disorders (2022) · cites this paper as [22]
The Background reports different levels of physician support for euthanasia in psychiatric versus severe physical illness, and the Discussion describes difficulties assessing prospects for improvement in psychiatric disorders. Neither passage addresses an ethical distinction between helping a dying person die peacefully and providing death to a non-dying person. Searches for that distinction and for dying versus non-dying patients found no passage stating it. (LLM, conf=0.76)
Experimental — accuracy not yet measuredMAiD-NT may put vulnerable or marginalized people at risk of seeking death as a relief from poverty, loneliness, or other psychosocial stressors.
“the difficulty that MAiD-NT may put vulnerable or marginalized people at risk of seeking death as a relief from poverty, loneliness, or other psychosocial stressors”
From Debating Euthanasia and Physician-Assisted Death in People with Psychiatric Disorders (2022) · cites this paper as [22]
The Methods (Questionnaire) and Results (The acceptability and conceivability of EAS in people with psychiatric disorders; pages unavailable) examine attitudes toward assisted dying for psychiatric suffering. Searches for vulnerability, poverty, loneliness, and social stressors found no passage addressing the claimed risk of seeking death for relief from those circumstances. (LLM, conf=0.75)
Experimental — accuracy not yet measured
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“56 Other studies similarly report that family members tend to support their loved ones’ MAiD MD-SUMC requests, citing relief of suffering and the perception of a dignified, controlled death.”
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- Authors
- Evenblij, K., Pasman, H. R. W., van der Heide, A., van Delden, J. J. M., & Onwuteaka-Philipsen, B. D.
- Affiliations
- Amsterdam Public Health (NL)
- Corresponding author
- Evenblij, Kirsten
- Venue
- BMC Medical Ethics
- Published
- 2019-09-11
- Volume
- 20
- Issue
- 1
- Pages
- 62-62
- ISSN
- 1472-6939 (ISSN-L)
- PMC
- PMC6737595
- OpenAlex
- W2972813530
- Cited by
- 35
- References
- 15
- Citations by year
- 2026: 6 · 2025: 3 · 2024: 8 · 2023: 4 · 2022: 4 · 2021: 6 · 2020: 4
- FWCI
- 3.22
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Locations
- BMC Medical Ethics (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Pure Amsterdam UMC (publishedVersion, cc-by)
- Amsterdam UMC (VU Amsterdam) - Institutional Repository (publishedVersion, other-oa)
- EUR Research Repository (Erasmus University Rotterdam) (publishedVersion, other-oa)
- EUR Research Repository (Erasmus University Rotterdam) (submittedVersion, other-oa)
- RePub (Erasmus University Rotterdam) (submittedVersion, other-oa)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Utrecht University Repository (Utrecht University) (submittedVersion, other-oa)
- RePub (Erasmus University Rotterdam) (submittedVersion)
- Data Archiving and Networked Services (DANS) (submittedVersion, other-oa)
- Funders
- ZonMw (3400.8002)
- Topics
- 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
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Ethics and bioethics in healthcare
- Keywords
- euthanasia, assisted suicide, mental illness, public opinion, physician attitudes, psychiatrists, general practitioners, eligibility criteria, religious beliefs, educational attainment, urbanization, medical specialization
- MeSH terms
- Mental Disorders, Cross-Sectional Studies, Decision Making, Educational Status, Euthanasia, Humans, Health Knowledge, Attitudes, Practice, Netherlands, Physicians, Public Opinion, Quality of Life, Persons with Psychiatric Disorders
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