安乐死:精神病患者是否应该被系统地排除在外?

Emilie Olié , Philippe Courtet
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摘要

据报道,在实施安乐死或协助自杀(EAS)的国家中,要求安乐死或辅助自杀的精神病患者人数有所增加。EAS提出的这场辩论邀请精神病学家思考他们在这个社会问题中的作用。如果说对遭受难以忍受的身体痛苦的患者实施安乐死是激烈的伦理辩论的主题,那么在遭受无法忍受的精神痛苦的情况下,这场辩论就更加激烈了。在这篇文章中,我们讨论了关于精神病患者EAS的三个要点。首先,我们质疑这种情况的不可逆性和相关的医疗无效性的概念。第二,我们注重在这种情况下作出知情决定的能力。第三,我们询问精神性EAS是否应该被视为传统自杀的翻版,还是一种额外的治疗选择。精神病学家应该制定实践指南,参与EAS的辩论并制定研究计划。
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Euthanasia: Should psychiatric patients be systematically excluded?

An increase of the number of psychiatric patients requesting euthanasia or assisted suicide (EAS) has been reported in countries practicing EAS. The debate raised by EAS invites psychiatrists to think about their role in this societal issue. If euthanasia for patients with unbearable somatic suffering is the subject of fierce ethical debate, the debate is even fiercer in cases of unbearable psychiatric suffering. In this manuscript, we discuss 3 main points concerning EAS for psychiatric patients. First, we question the notion of irreversibility of the condition and the related medical futility. Second, we focus on the capacity to make informed decisions in such situations. Third, we ask whether psychiatric EAS should be considered as a copycat of traditional suicide or an additional therapeutic alternative. Psychiatrists should produce practice guidelines to be involved in the EAS debate and develop research programs.

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