phase. Psychiatry is a broad specialty, and subtle nuances can be easily missed if a clinician does not have extensive experience with a specific disorder. Utmost care and expert evaluation are required, especially in matters of life or death. Although the Dutch Psychiatric Association’s new guideline further clarifies and sharpens the duediligence process, several challenges remain. For instance, when patients suffer from multiple disorders, it is unclear which specialist should be consulted. Furthermore, the attitudes of Dutch specialized psychiatrists concerning the obligation to seek a second opinion have not yet been investigated. CONCLUSIONS Physician-assisted death among patients with a psychiatric disorder is an emerging and controversial issue around the world that poses substantial ethical challenges. The fact that physician-assisted death is legal for psychiatric patients in some countries provides the opportunity to learn from actual cases. The case presented here of a psychiatric patient who requested physician-assisted death, only to recover after adequate diagnosis and treatment by an independent specialist, can serve as a basis for further debate. On one hand, it raises questions about whether relatively complex psychiatric diagnoses offer a sufficient basis for irreversible decisions such as physician-assisted death. On the other hand, it illustrates that thorough due-diligence procedures can lead to recovery, even at a late stage, which would not have occurred if the patient and the treating physician had continued treatment without a second opinion. This case shows the importance of taking the request for physician assisted death of a patient with a psychiatric disorder seriously and investigating it further by seeking a second opinion from an independent psychiatrist specialized in the patient’s disorder. 34 | PART I - CHAPTER 2 2
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