About this Research Topic
Medically Assisted Suicide is a significant and contested matter not only from a bioethical perspective but also from a psychiatric one, necessitating thorough exploration and understanding in numerous nations globally. Western countries exhibit diverse psychiatric regulations and practices concerning both euthanasia and medically assisted suicide (E/PAS). While some nations permit E/PAS under specific conditions associated with unbearable psychiatric suffering or treatment-resistant mental health disorders, others haven't extended its practice to these disorders yet, allowing E/PAS only under certain medical conditions. Evaluating the mental competency of patients who choose E/PAS and defining 'unbearable psychological distress' are central psychiatric issues in this practice. Additionally, the ethical implications of extending E/PAS to minors and individuals with neurological disorders or those dependent on life-support treatments uncovers another area warranting comprehensive scrutiny.
This Research Topic seeks to delve into the evolving psychiatric approaches and policies regarding E/PAS in different nations where it's permitted, aiming to identify universally recognized criteria that could serve as guiding principles for countries crafting their unique regulations. Studies evaluating the prevalence of cases for psychiatric patients, with particular focus on subjects diagnosed with Severe Mental Illness (e.g., Schizophrenia spectrum disorder, unipolar depression or bipolar disorder, severe personality disorders), and with neurological diagnoses (e.g., dementia, autistic spectrum disorder) will be highly welcomed.
Additionally, studies investigating the comorbidity of psychiatric disorders or psychological distress in individuals with somatic pathologies for which end-of-life assistance is provided are required. The aim is to understand how these two conditions intertwine and influence the evaluation of access to E/PAS.
Studies providing insight into cognitive and/or neuroimaging mechanisms that may influence patients' decisions to access E/PAS, regardless of the presence of mental and/or neurological disorders, will also be valuable alongside prevalence data. Another necessary focus is on alternative strategies to offer to individuals requesting access to E/PAS for mental disorders. What are the latest developments in psychiatric and/or neurological fields in this regard? Are there pharmacological, somatic therapies, or rehabilitative proposals that could be considered before resorting to E/PAS for these cases? If so, for which diagnostic categories have they been proposed? What are the potential future developments?
Finally, it will be essential to refine the standardization of procedures used in the psychiatric evaluation of patients seeking E/PAS. This includes research related to refining and validating procedures and assessment tools for:
- Evaluating mental capacity to make decisions about assisted suicide
- Defining and assessing 'unbearable and unrelievable mental distress'
- Establishing criteria for 'absence of prospects for improvement'
- Clarity and exploration of the concept of dependence on life-support treatments, redefined here in its broadest sense as any medical treatment interruption leading potentially to the patient’s death.
This Research Topic seeks to delve into the evolving psychiatric approaches and policies regarding E/PAS in different nations where it's permitted, aiming to identify universally recognized criteria that could serve as guiding principles for countries crafting their unique regulations. Studies evaluating the prevalence of cases for psychiatric patients, with particular focus on subjects diagnosed with Severe Mental Illness (e.g., Schizophrenia spectrum disorder, unipolar depression or bipolar disorder, severe personality disorders), and with neurological diagnoses (e.g., dementia, autistic spectrum disorder) will be highly welcomed.
Additionally, studies investigating the comorbidity of psychiatric disorders or psychological distress in individuals with somatic pathologies for which end-of-life assistance is provided are required. The aim is to understand how these two conditions intertwine and influence the evaluation of access to E/PAS.
Studies providing insight into cognitive and/or neuroimaging mechanisms that may influence patients' decisions to access E/PAS, regardless of the presence of mental and/or neurological disorders, will also be valuable alongside prevalence data. Another necessary focus is on alternative strategies to offer to individuals requesting access to E/PAS for mental disorders. What are the latest developments in psychiatric and/or neurological fields in this regard? Are there pharmacological, somatic therapies, or rehabilitative proposals that could be considered before resorting to E/PAS for these cases? If so, for which diagnostic categories have they been proposed? What are the potential future developments?
Finally, it will be essential to refine the standardization of procedures used in the psychiatric evaluation of patients seeking E/PAS. This includes research related to refining and validating procedures and assessment tools for:
- Evaluating mental capacity to make decisions about assisted suicide
- Defining and assessing 'unbearable and unrelievable mental distress'
- Establishing criteria for 'absence of prospects for improvement'
- Clarity and exploration of the concept of dependence on life-support treatments, redefined here in its broadest sense as any medical treatment interruption leading potentially to the patient’s death.
Keywords: medically assisted suicide, E/PAS, psychiatric ethics, psychiatry, mental illness, assisted dying, suicide, ethics, autonomy, unbearable suffering, decision-making capacity, end-of-life, treatment resistance
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