When unbearable suffering incites psychiatric patients to request euthanasia: qualitative study

The concept of 'unbearable suffering' is central to legislation governing whether euthanasia requests may be granted, but remains insufficiently understood, especially in relation to psychiatric patients. To provide insights into the suffering experiences of psychiatric patients who have m...

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Bibliographic Details
Published in:British journal of psychiatry 2017-10, Vol.211 (4), p.238-245
Main Authors: Verhofstadt, Monica, Thienpont, Lieve, Peters, Gjalt-Jorn Ygram
Format: Article
Language:English
Subjects:
Adult
Aged
Aged, 80 and over
Assisted suicide
Competence
Euthanasia
Euthanasia - legislation & jurisprudence
Euthanasia - psychology
Female
Hopelessness
Humans
Inequality
Legislation
Male
Measurement
Mental disorders
Mental Disorders - complications
Mental Disorders - psychology
Middle Aged
Patients
Physicians
Psychiatry
Qualitative Research
Stress, Psychological - complications
Stress, Psychological - psychology
Suffering
Suicides & suicide attempts
Young Adult
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Summary:The concept of 'unbearable suffering' is central to legislation governing whether euthanasia requests may be granted, but remains insufficiently understood, especially in relation to psychiatric patients. To provide insights into the suffering experiences of psychiatric patients who have made a request for euthanasia. Testimonials from 26 psychiatric patients who requested euthanasia were analysed using QualiCoder software. Five domains of suffering were identified: medical, intrapersonal, interpersonal, societal and existential. Hopelessness was confirmed to be an important contributor. The lengthy process of applying for euthanasia was a cause of suffering and added to experienced hopelessness, whereas encountering physicians who took requests seriously could offer new perspectives on treatment. The development of measurement instruments to assess the nature and extent of suffering as experienced by psychiatric patients could help both patients and physicians to better navigate the complicated and sensitive process of evaluating requests in a humane and competent way. Some correlates of suffering (such as low income) indicate the need for a broad medical, societal and political debate on how to reduce the burden of financial and socioeconomic difficulties and inequalities in order to reduce patients' desire for euthanasia. Euthanasia should never be seen (or used) as a means of resolving societal failures.
ISSN:0007-1250
1472-1465
DOI:10.1192/bjp.bp.117.199331