INTRODUCTION The Netherlands is one of the few countries in the world that allows euthanasia or assisted suicide (PAD). The vast majority of Dutch patients who choose PAD are terminally ill cancer patients with a limited life expectancy. However, the number of psychiatric cases is rising (Onwuteaka-Philipsen et al., 2017) Quantitative studies addressing this topic are scarce (Dierickx, Deliens, Cohen, & Chambaere, 2017; Doernberg, Peteet, & Kim, 2016; Groenewoud et al., 1997; Kim, de Vries, & Peteet, 2016; Schoevers, Asmus, & Van Tilburg, 1998; Thienpont et al., 2015; Tuffrey-Wijne, Curfs, Finlay, & Hollins, 2018). As a result, much is still unknown about the characteristics of Dutch psychiatric patients who die by means of PAD, the procedure that precedes this, and the reviewing process that follows. The fact that PAD for psychiatric patients is accepted in the Netherlands offers a rare opportunity to quantitatively study the effects of a liberal end-of-life policy. In 2016, Kim et al. analyzed the online reports of the regional euthanasia review committees (RTE) between 2011 and 2014. Their research showed that psychiatric patients receiving PAD in the Netherlands are mostly women suffering from complex and chronic psychiatric disorders. 76% of patients were above 50. They also found that physicians were thorough in their analysis and sometimes disagreed about meeting due diligence requirements. Finally, they concluded that the RTE almost always follow the medical opinion of the reporting physician. More than three years have passed since the Kim et al. review period (2011-2014) and the RTE continue to share part of their anonymized reports online. We analyzed the reports that were published between 2015 and 2017, enabling us to study how the psychiatric PAD practice is developing in the Netherlands. Our objective is to help inform the ethical debate on the subject of PAD among psychiatric patients. BACKGROUND For several decades, the Netherlands has taken a liberal stance on end-of-life topics, which was formalized through the “Termination of Life on Request and Assisted Suicide Act” in 2002. This act does not exclude psychiatric patients, but for years only one or two psychiatric cases were reported each year. (Onwuteaka-Philipsen et al., 2017) However, since 2012 this number has been rising, going from 2 reported cases in 2011 to 83 cases in 2017. (RTE, 2017) Although no correlation has been demonstrated, this increase does coincide with the opening of the End-of-Life clinic (EOL clinic). This private institution provides counseling and second opinions for patients who cannot EUTHANASIA OF DUTCH PATIENTS WITH PSYCHIATRIC DISORDERS BETWEEN 2015 AND 2017 | 39 3
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