Bioethics Blogs

The Case for Expanding Physician-Assisted Death to Psychiatric Conditions

Should people suffering from psychiatric conditions, such as severe, prolonged depression, that have not responded to treatment, be eligible for physician-assisted death? Most jurisdictions that allow PAD do not permit it for psychiatric conditions. However, though rare, it is allowed in Belgium and the Netherlands. Some regard the expansion to psychiatric conditions as evidence of an inevitable slippery slope and a reason why PAD should not be legalized at all. Others think that while PAD should be limited to terminal, physical illness, a slippery slope to other conditions is not inevitable. And still others think that there is a case for inclusion of some psychiatric conditions.

 I will argue that the case for absolute exclusion of psychiatric conditions has not been made. It may be justified, in some cases and under certain conditions. Assisted death should always be a last resort, whether the condition prompting the request is physical illness or psychiatric condition.

One reason that has been given for why PAD should not be available to psychiatric patients is that this conflicts with role of psychiatrists. However, the same could be said about PAD for physical illness. Some opponents of PAD argue that physicians should be healers, not killers. Therefore, it seems that reflection on the role of psychiatrists cannot be used specifically to rule out PAD for psychiatric conditions.

It should also be noted that not all physicians agree that assistance in dying is inconsistent with the physician’s role. Some maintain that if a patient is dying, and nothing can be done to reverse the dying process, then healing is no longer possible.

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.