This narrative review examines euthanasia and assisted suicide requests from patients with mental disorders. The authors looked at how different legal models and clinical approaches handle key issues like decision-making capacity and the assessment of suffering. The study did not report specific numbers or results from a single trial because it is a review of existing information.
The review found considerable variability in how these issues are handled. For example, there is no standardized criteria for determining if suffering is irremediable. Legal models and clinical approaches also vary widely regarding subjective suffering and voluntariness. Safeguard systems show similar differences across different regions and jurisdictions.
Despite these differences, there is a shared emphasis on using repeated, multidisciplinary, and well-documented evaluation processes. The authors suggest that structured and multidisciplinary evaluation processes may help enhance consistency and ethical sustainability. Longitudinal assessment and detailed reconstruction of clinical history appear to be key elements in supporting reliable decision-making. Multidisciplinary approaches involving clinical psychiatry, forensic psychiatry, and legal medicine may contribute to improving consistency, transparency, and medico-legal robustness. The review notes that uncertainties regarding these complex issues cannot be fully resolved.
