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Cited by 23Ethics and bioethics in healthcarePalliative Care and End-of-Life IssuesHealthcare Decision-Making and Restraints

Perceived Burdensomeness and the Wish for Hastened Death in Persons With Severe and Persistent Mental Illness

Open access
Stoll, Julia, Ryan, Christopher James, Trachsel, Manuel·2021·Frontiers in Psychiatry
DOI 10.3389/fpsyt.2020.532817PMC PMC7835407
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Abstract

Background: In several European countries, medical assistance in dying (MAID) is no longer confined to persons with a terminal prognosis but is also available to those suffering from persistent and unbearable mental illness. To date, scholarly discourse on MAID in this population has been dominated by issues such as decision-making capacity, uncertainty as to when a disease is incurable, stigmatization, isolation, and loneliness. However, the issue of perceived burdensomeness has received little attention. Objective: The study explores the possible impact of perceived burdensomeness on requests for MAID among persons with severe and persistent mental illness (SPMI). Method: Using the method of ethical argumentation, we discuss the issue of access to MAID for persons with SPMI and perceived burdensomeness. Conclusion: Perceived burdensomeness may be a contributing factor in the wish for hastened death among persons with SPMI. MAID is ethically unsupportable if SPMI causes the individual to make an unrealistic assessment of burdensomeness, indicating a lack of decision-making capacity in the context of that request. However, the possibility that some individuals with SPMI may perceive burdensomeness does not mean that they should be routinely excluded from MAID. For SPMI patients with intact decision-making capacity who feel their life is not worth living, perceived burdensomeness as a component of this intolerable suffering is not a sufficient reason to deny access to MAID.

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  1. [8]Termination of Life on Request and Assisted Suicide Review Procedures Act (2002), 26 691, no. 137 of the 2000–2001 Parliamentary Session That Went Into Effect (2002).
  2. [22]Joiner TE Jr Why People Die by Suicide. Cambridge, MA: Harvard University Press (2005).
  3. [40]Beck AT Rush AJ Shaw BF Emery G Cognitive Therapy of Depression. New York, NY: Guilford Press (1987).

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Authors
Stoll, J., Ryan, C. J., & Trachsel, M.
Affiliations
  • The University of Sydney (AU)
  • University of Zurich (CH)
Corresponding author
Trachsel, Manuel
ORCID
Venue
Frontiers in Psychiatry
Publisher
Frontiers Media SA
Published
2021-01-12
Volume
11
Pages
532817-532817
ISSN
1664-0640 (ISSN-L)
DOI
10.3389/fpsyt.2020.532817
PMC
PMC7835407
OpenAlex
W3121103083
Cited by
20
References
50
Citations by year
2026: 2 · 2025: 5 · 2024: 2 · 2023: 7 · 2022: 2 · 2021: 2
FWCI
3.03
Type
journal article
Language
en
Open access
Licence
Locations
  • Frontiers in Psychiatry (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • Zurich Open Repository and Archive (University of Zurich) (acceptedVersion, cc-by)
  • UNSWorks (University of New South Wales, Sydney, Australia) (submittedVersion, cc-by-nc-nd)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
  • Zurich Open Repository and Archive (University of Zurich) (submittedVersion, cc-by)
  • Zurich Open Repository and Archive (University of Zurich)
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 Care and End-of-Life Issues
  • Social Sciences › Psychology › Clinical Psychology › Healthcare Decision-Making and Restraints
Keywords
medical assistance in dying, perceived burdensomeness, severe and persistent mental illness, decision-making capacity, ethical argumentation, ethics of euthanasia

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