criteria from the Delphi-study can also be used by clinicians to guide decision-making. Furthermore, countries that are currently contemplating expanding PAD to psychiatric suffering, such as Canada and Spain, can use this dissertation as inspiration for their due diligence procedures for PAD. Also, and more specifically, the suggestion that treatment fatigue is an important factor among patients requesting PAD deserves more attention in clinical practice. This can be done by introducing the concept of treatment fatigue in daily practice and by discussing it with patients to see if it resonates. But another way to foster this is to add a chapter to treatment guidelines that describes when it is prudent to stop pursuing curative treatment and what to do then. The criteria for irremediability can serve as an inspiration and can be adjusted to suit specific disorders. As a field, psychiatry has spent considerable time, energy and resources on step-up treatment strategies for ‘therapy resistant’ patients. In our view it is necessary to also become aware about the risks of hyper-interventionalism and start to think more about when acceptancebased strategies are more suitable and when to stop steering toward recovery, even if this might eventually mean death. (Trachsel et al., 2016) Finally, by showing the significant complexity of establishing IPS, we hope to contribute to the societal discussion about PAD for PPD. Often psychiatrists are portrayed as ‘unwilling’ or ‘uncooperative’ when it comes to PAD and indeed the access to PAD for PPD appears to be a problem in the Netherlands. (van Veen & Widdershoven, 2021) Our research shows that psychiatrists are requested to make a life-or-death choice while facing uncertainty. This causes moral stress that is not often recognized in the societal discussion, which can lead to frustration and mistrust. Fortunately, our research also shows that in the end expert-consensus about a careful establishment of IPS is possible. We hope that more clarity about the complexity of IPS will create understanding for psychiatrists. At the same time, we hope that the intersubjective criteria will help psychiatrists to establish IPS. Recommendations for research Based on the findings in this dissertation several recommendations can also be made for future research. First, in this dissertation we focused on the perspective of the psychiatrist, but the views of other stakeholders should also be studied. To start with the psychiatrist perspective is logical from a legal point of view, because both in Belgium and the Netherlands the actions of the physician are legally investigated. However, as we have argued throughout this dissertation, in clinical practice shared decision making is essential, a fact that is reflected in clinical guidelines and codes of practice. Therefore, studying the GENERAL DISCUSSION | 129 7