0
views
0
recommends
+1 Recommend
0 collections
    0
    shares
      • Record: found
      • Abstract: found
      • Article: found
      Is Open Access

      Perspectives on physician-assisted suicide in mental healthcare: results of a survey of physicians and medical students

      research-article

      Read this article at

      Bookmark
          There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

          Abstract

          Background

          Physician-assisted suicide (PAS) is typically associated with serious physical illnesses that are prevalent in palliative care. However, individuals with mental illnesses may also experience such severity that life becomes intolerable. In February 2020, the previous German law prohibiting PAS was repealed. Patients with severe mental illnesses are increasingly likely to approach physicians with requests for PAS.

          Aims

          To explore the ethical and moral perspectives of medical students and physicians when making individual decisions regarding PAS.

          Method

          An anonymised digital survey was conducted among medical students and physicians in Germany. Participants were presented with a case vignette of a chronically depressed patient requesting PAS. Participants decided on PAS provision and assessed theoretical arguments. We employed generalised ordinal regression and qualitative analysis for data interpretation.

          Results

          A total of N = 1478 participants completed the survey. Of these, n = 470 (32%) stated that they would refuse the request, whereas n = 582 (39%) would probably refuse, n = 375 (25%) would probably agree and n = 57 (4%) would definitely agree. Patient-centred arguments such as the right to self-determination increased the likelihood of consent. Concerns that PAS for chronically depressed patients might erode trust in the medical profession resulted in a decreased willingness to provide PAS.

          Conclusions

          Participants displayed relatively low willingness to consider PAS in the case of a chronically depressed patient. This study highlights the substantial influence of theoretical medical-ethical arguments and the broader public discourse, underscoring the necessity of an ethical discussion on PAS for mental illnesses.

          Related collections

          Most cited references37

          • Record: found
          • Abstract: found
          • Article: not found

          Risks of all-cause and suicide mortality in mental disorders: a meta-review.

          A meta-review, or review of systematic reviews, was conducted to explore the risks of all-cause and suicide mortality in major mental disorders. A systematic search generated 407 relevant reviews, of which 20 reported mortality risks in 20 different mental disorders and included over 1.7 million patients and over a quarter of a million deaths. All disorders had an increased risk of all-cause mortality compared with the general population, and many had mortality risks larger than or comparable to heavy smoking. Those with the highest all-cause mortality ratios were substance use disorders and anorexia nervosa. These higher mortality risks translate into substantial (10-20 years) reductions in life expectancy. Borderline personality disorder, anorexia nervosa, depression and bipolar disorder had the highest suicide risks. Notable gaps were identified in the review literature, and the quality of the included reviews was typically low. The excess risks of mortality and suicide in all mental disorders justify a higher priority for the research, prevention, and treatment of the determinants of premature death in psychiatric patients. Copyright © 2014 World Psychiatric Association.
            Bookmark
            • Record: found
            • Abstract: found
            • Article: not found

            Attitudes and Practices of Euthanasia and Physician-Assisted Suicide in the United States, Canada, and Europe.

            The increasing legalization of euthanasia and physician-assisted suicide worldwide makes it important to understand related attitudes and practices.
              Bookmark
              • Record: found
              • Abstract: not found
              • Article: not found

              Assessing Proportionality in the Proportional Odds Model for Ordinal Logistic Regression

                Bookmark

                Author and article information

                Journal
                BJPsych Open
                BJPsych Open
                BJO
                BJPsych Open
                Cambridge University Press (Cambridge, UK )
                2056-4724
                September 2024
                07 August 2024
                : 10
                : 5
                : e141
                Affiliations
                [1]Department of Psychiatry and Psychotherapy, University Hospital Tuebingen, University of Tuebingen , Tuebingen, Germany
                [2]Department of Psychosomatic Medicine and Psychotherapy, University Hospital Tuebingen, University of Tuebingen , Tuebingen, Germany
                [3]Institute of Ethics and History of Medicine, Eberhard Karls University Tuebingen , Tuebingen, Germany
                [4]Department of Psychosomatic Medicine and Psychotherapy, Otto von Guericke University Magdeburg, University Hospital Magdeburg , Magdeburg, Germany; and German Center for Mental Health , Magdeburg, Germany
                [5]Tuebingen Institute for Medical Education, University of Tuebingen , Tuebingen, Germany; and German Center for Mental Health , Tuebingen, Germany
                [6]Department of Psychiatry and Psychotherapy, University Hospital Tuebingen, University of Tuebingen , Tuebingen, Germany; and German Center for Mental Health , Tuebingen, Germany
                [7]Department of Psychosomatic Medicine and Psychotherapy, University Hospital Tuebingen, University of Tuebingen , Tuebingen, Germany; and German Center for Mental Health , Tuebingen, Germany
                Author notes
                Correspondence: Sophia Helen Adam. Email: sophia.adam@ 123456med.uni-tuebingen.de
                Author information
                https://orcid.org/0009-0006-8845-5924
                https://orcid.org/0000-0003-4824-8163
                https://orcid.org/0000-0001-5900-2228
                https://orcid.org/0000-0002-3925-6949
                https://orcid.org/0000-0003-2413-7047
                https://orcid.org/0000-0001-7713-4259
                https://orcid.org/0000-0003-1659-4440
                https://orcid.org/0000-0002-4433-9378
                Article
                S2056472424007312
                10.1192/bjo.2024.731
                11698214
                39108029
                bb61b494-ddc7-4dc1-be2d-bf3ff2e48beb
                © The Author(s) 2024

                This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution and reproduction, provided the original article is properly cited.

                History
                : 10 October 2023
                : 16 May 2024
                : 20 May 2024
                Page count
                Figures: 4, References: 48, Pages: 9
                Categories
                Paper

                depressive disorders,physician-assisted suicide,medical profession,medical survey,ethical perspective

                Comments

                Comment on this article