Euthanasia for mental ailments is ‘suicide assistance’

After the tragic deaths last month of fashion designer Kate Spade and celebrity chef Anthony Bourdain, mental health professionals emphasized the need to recognize suicide risk and the importance of seeking help for those suffering with depression and suicidal thoughts.

Yet as more countries embrace euthanasia and physician-assisted suicide, is there a danger that “suicide prevention” might shift to “suicide assistance”?

Earlier this year, medical professionals in the Netherlands performed euthanasia on a 29-year-old woman suffering from depression and other mental ailments, after the country liberalized its euthanasia laws – some of the most permissive in the world – to include allowing it for those with mental illnesses.

Euthanasia for people who are not terminally ill, but suffering psychiatric disorders, is also legal in Belgium.

“Psychiatrists and mental health professionals are precisely the kind of persons those who are suicidal might go to for help. The shift to suicide assistance, by the very people whose role we customarily think of as being suicide prevention, is one that will therefore interest and, indeed, alarm many,” said Michael Wee, the education officer at the Oxford-based Anscombe Bioethics Centre.

The center is a Catholic academic institute that engages with the moral questions arising in clinical practice and biomedical research, and this week is holding a three-day symposium on the ethics of psychiatry and mental health care.

The final day of the event will look at the ethics surrounding suicide and euthanasia.

“We wanted to highlight the way that physician-assisted suicide is also a mental health issue and that the norms of suicide prevention should also apply to people to are seeking to end their lives by assisted suicide,” said David Albert Jones, the director of the center.

Jones said that all instances of assisted suicide – including for the elderly and disabled – raise the mental health issue of undiagnosed depression, but he said it is “even more problematic” when mental health issues are used as a justification for performing euthanasia or assisted suicide (the difference being that the doctor performs the action which causes death in euthanasia, while in physician-assisted suicide, the actual action is performed by the patient.)

“This places psychiatrists in the situation of being asked to assist in the suicide of patients who experience suicidal ideation,” Jones said.

“Psychiatrists are often put under pressure to ‘grant’ euthanasia, sometimes even by the family of a patient,” he said.

Lemmens said the situation – as well as some “worrisome cases” of the euthanizing of mental health patients reported in the press – has created “a sphere of mutual distrust among psychiatrists.”