Opponents of legalized euthanasia have often warned of a slippery slope that would see the extension of assisted suicide to more and more categories of persons.
Recent events have provided confirmation that these fears were well founded. From Holland news came that a victim of sexual abuse in her 20s was allowed to undergo euthanasia due to her mental health condition of post-traumatic stress disorder.
The unnamed woman was given a lethal injection despite improvements in her psychological condition following therapy two years ago, Britain’s Daily Mail newspaper reported on May 11.
“It is both horrifying and worrying that mental health professionals could regard euthanasia in any form as an answer to the complex and deep wounds that result from sexual abuse,” Nikki Kenward, of the disability rights group Distant Voices, told the Daily Mail.
Concerns about the use of euthanasia for mental health patients were raised in the article “Euthanasia and Assisted Suicide of Patients With Psychiatric Disorders in the Netherlands 2011 to 2014,” published February 10 by the journal JAMA Psychiatry.
The authors reviewed 66 cases of persons with chronic or severe psychiatric conditions who requested assisted suicide.
Isolation and loneliness
The study identified a number of issues that raised concern about whether alternatives to euthanasia could have had success in treating the problems experienced. Regarding the psychiatric problems suffered by the people, disorders related to depression — 55% of the cases — were the most prevalent. As well, 56% of the reports mentioned social isolation or loneliness as a factor.
There were disagreements among the physicians in almost a quarter of the cases. Then, in assessing the reports on the cases, the study found that their length had diminished significantly over the time span covered and that the assessment section of the reports on the cases used language without case-specific elements in 65% of the reports.
Added to this was the fact that for 18 patients the physician involved in the assisted suicide was new to the patient and for 14 of these the physician was with a mobile euthanasia clinic.
“The Dutch system is really the idealized setting in which to try something like this,” said lead author of the study, Dr. Scott Y. H. Kim, a psychiatrist and bioethicist at the National Institutes of Health.
“But still, you can see that there are many cases that make us question whether this is the right practice,” Kim told the New York Times in its Feb. 11 report on the study.
Just prior to the study’s publication the Dutch government announced that euthanasia would be extended to persons suffering from dementia. Euthanasia would be allowed even if the person was mentally incompetent to request it, provided they had previously asked for it while still competent.
In his January 7 blog report on the news, Alex Schadenberg, chair of the Euthanasia Prevention Coalition, noted that the 2014 Netherlands euthanasia statistics said that out of 5,306 euthanasia deaths; 81 people were lethally injected for dementia and 41 people died by euthanasia for psychiatric reasons.
In spite of the problems raised by the JAMA Psychiatry study some Dutch euthanasia advocates want to extend the possibilities even further.
Paulan Stärcke, a Dutch psychiatrist, who has herself carried out euthanasia requests, said that psychiatrists are “too hesitant” about agreeing to euthanasia for patients with psychiatric diseases, according to a report dated May 11 by London’s Telegraph newspaper.
She told the Telegraph that euthanasia requests from children as young as 12 years old should be taken seriously.
Number of cases rising
Her comments come against a background of significant increases in euthanasia numbers in places where it is legal.
There were 2,021 cases of assisted suicide in Belgium in 2015, the government reported earlier this year. This compares with 1,924 in 2014, with the number of cases only exceeding 1,000 for the first time in 2011, according to an AFP report on January 27.
In Switzerland the assisted suicide organization EXIT helped end the lives 782 people in 2015, 199 more than the previous year, the news agency Swissinfo reported on March 2.
In the American state of Oregon the government report for 2015 said that 218 people received prescriptions for lethal medications compared to 155 in 2014.
From 1998 to 2012 the number of prescriptions grew at an average annual rate of 12.1%, but for 2014-2015 this increased sharply to 24.4%.
Help those with mental health problems, don’t facilitate their deaths, was the plea from Denise Batters, a Canadian senator from the province of Saskatchewan.
As Canada debates the form of a law to allow euthanasia, she made her plea in an article published March 14 in the country’s National Post newspaper. Batters explained that she lost her husband to suicide in 2009, after he struggled with anxiety and depression.
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Psychological treatment can be of great help to people, but there are serious gaps in Canada’s mental health care system, she explained.
“The preservation of hope for mentally ill people is absolutely paramount,” Batters exclaimed.
“Those who endure psychological suffering need our support, our resources and our promise that we will never give up on them, even when they can see no other option but to give up on themselves,” she said.
The very real risk is that with aging populations and increasing pressure on health care budgets, euthanasia will be an increasingly tempting way to deal with those suffering from mental health problems.