Fenne Bosma, Kelly Romana Mink, Johannes Jozef Marten van Delden, Agnes van der Heide, Suzanne van de Vathorst, Ghislaine Jose Madeleine Wilhelmien van Thiel
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引用次数: 0
摘要
重要性：对患有精神障碍（PD）的病人实施安乐死或协助自杀（EAS）在全世界都是一个有争议的话题。在荷兰，这种做法受法律监管。所有 EAS 病例都必须上报，并由地区安乐死审查委员会 (RTE) 进行评估，该委员会会在其网站上公布所有病例的选编：目的：深入了解荷兰对精神疾病患者实施安乐死的情况：我们进行了一项回顾性病例研究，分析了 2017 年至 2022 年间所有已公布的精神疾病患者 EAS 病例：不适用：主要结果和测量：因罹患PD而死于EAS的患者的特征、报告医生和顾问的特征以及RTE对已发表病例的评估：在研究的72个病例中，大多数患者为女性（48人，占67%），患有3种或3种以上疾病（38人，占53%），死于安乐死而非协助自杀（56人，占78%）。在 63% 的病例中（n=45），生命终止是由安乐死专家中心（EE）的医生实施的。在所有病例中，RTE 判断病例不符合适当护理标准（n=11）都与独立医生或精神病专家的（建议）问题有关：这项定性研究表明，RTE 非常重视对处理 EAS 申请的医生进行仔细评估的程序，以及医生对其观点进行反思的能力，尤其是当独立顾问对病例的评估与医生不同时。对医生进行培训，并提高对腹膜透析患者简易手术申请评估的透明度，可能会降低医生自行处理这些患者申请的门槛：试验注册：不适用。
The Dutch practice of euthanasia and assisted suicide in patients suffering from psychiatric disorders: a qualitative case review study.
Importance: Euthanasia or assisted suicide (EAS) in patients suffering from a psychiatric disorder (PD) is a controversial topic worldwide. In the Netherlands, this practice is regulated by law. All cases of EAS have to be reported and are assessed by the Regional Euthanasia Review Committees (RTEs), who publish a selection of all cases on their website.
Objective: To provide insight into the Dutch practice of EAS in patients suffering from a psychiatric disorder.
Design setting and participants: We performed a retrospective case review study in which all published cases of EAS in patients suffering from a PD between 2017 and 2022 were analyzed.
Interventions or exposures: Not applicable.
Main outcomes and measures: Characteristics of patients who died by EAS because of suffering from a PD, characteristics of the reporting physician and consultant(s) and the RTEs assessment of published cases.
Results: Of the 72 cases studied, the majority of patients were female (n=48, 67%), suffered from 3 or more conditions (n=38, 53%) and died by euthanasia instead of assistance in suicide (n=56, 78%). In 63% of cases (n=45), the life termination was performed by a physician from the Euthanasia Expertise center (EE). The RTEs' judgement that the case did not meet the due care criteria (n=11) was in all cases related to issues regarding the (advice of the) independent physician or psychiatric expert.
Conclusion and relevance: This qualitative study shows that the RTEs attach great importance to a careful evaluation procedure of physicians handling EAS requests and to the physician demonstrating ability to reflect on his views, especially when the independent consultant evaluates the case different than the physician. Training for physicians and more transparency in the assessment of EAS requests in patients with a PD may lower the threshold for physicians to handle requests of these patients themselves.
期刊介绍：
Frontiers in Psychiatry publishes rigorously peer-reviewed research across a wide spectrum of translational, basic and clinical research. Field Chief Editor Stefan Borgwardt at the University of Basel is supported by an outstanding Editorial Board of international researchers. This multidisciplinary open-access journal is at the forefront of disseminating and communicating scientific knowledge and impactful discoveries to researchers, academics, clinicians and the public worldwide.
The journal''s mission is to use translational approaches to improve therapeutic options for mental illness and consequently to improve patient treatment outcomes.
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