The Shanti De Corte case: euthanasia for mental disorder between clinic and bioethics, between law and medico-legal implications.

Abstract

Introduction: In recent months, a great uproar has been aroused by the case of a 23-year-old Belgian woman who requested and obtained euthanasia because she was suffering from a mental disorder, in the absence of any somatic pathology. The news raises some questions and stimulates some reflections both on the general theme of euthanasia carried out for the simple presence of a mental disorder, and for the indefiniteness of the clinical information on the case in question, as well as on the ethical and medico-legal questions connected to such indefiniteness.

Case presentation: The information on the case was derived essentially from the press and from websites, with no specific access to actual clinical documentation and without in-depth knowledge of case details. One wonders what the real clinical diagnosis of the patient was, only hypothetically identifiable in a Post-traumatic Stress Disorder associated with Major or Chronic Depressive Disorder, probably on the basis of a possible Personality Disorder. One wonders if all the necessary therapeutic interventions had been implemented, in a clinical case that did not theoretically have the characteristics of incurability. One wonders why the death request was considered valid, in a subject perhaps suffering from a mental disorder of such severity as to alter the ability to express valid consent to medical treatment. One wonders why the death request was not considered as an indicator of the severity of the disease, rather than simply being considered as a free choice of a subject capable of self-determination. One wonders why the negative opinion of the patient's family members was not considered.

Conclusions: Belgian legislation provides for euthanasia for patients suffering from mental disorders who, like those suffering from somatic disorders, experience a condition of constant, unbearable and incurable suffering. But the case in question raises numerous perplexities both on the clinical and ethical coherence of Belgian legislation and on the ways in which the rules of this legislation have been observed in this specific situation.