go to their own physician with an PAD request. The EOL clinic now performs around 75% of all cases of PAD based on psychiatric suffering. (Levenseindekliniek, 2017) Law dictates transparency and independent review, and an independent physician, preferably a specialized euthanasia consultant (SCEN-physician), must be consulted prior to the actual effectuation of PAD. All due diligence requirements of PAD have been described extensively before. (Kim et al., 2016) They include that suffering must be unbearable and without prospect of improvement, there must be no reasonable way to relieve this suffering, and the request has to be voluntary and well-considered by a competent patient. When it concerns psychiatric patients, according to the law, involvement of an independent consulting physician is enough. However, jurisprudence, formalized through the Code of Practice of the RTE, states that an independent specialized psychiatrist has to be consulted when “the euthanasia request results (largely) from mental suffering”. (Regional Euthanasia Review Committees, 2015) This requirement corresponds with the euthanasia guideline by the Dutch Association for Psychiatry (NVvP), which is currently under review. (Berghmans, Widdershoven, & WiddershovenHeerding, 2013) After PAD is performed, a coroner reports the case and the RTE assesses every case. Only when they conclude that due diligence requirements have not been met is the case then transferred to the public prosecutor for criminal investigation. METHODS Case selection All RTE reports of PAD between 2015 and 2017, labeled as psychiatric and published online before April 16, 2018, were screened. 43 reports were available: 24 from 2015, 10 from 2016 and 9 from 2017. 8 reports were excluded (case numbers: 2013-15, 2015-18, 2015-19, 2015-47, 2015-80, 2016-07, 2017-26, 2017-32 and one case from 2013). In six of the excluded reports, somatic suffering (sometimes terminal) was the main reason for PAD, and psychiatric complaints were either secondary or subsidiary in nature. One report was excluded because it was mistakenly duplicated online. One report was excluded because it was mislabeled and came from 2013. 35 reports were included for analysis. It is important to note that in 2015 the RTE publication policy was adjusted to a lower publishing rate of cases labeled as psychiatric. The argument supporting this is that disproportionate attention was given to psychiatric reports while they constitute less than 1% of all PAD cases. In their article, Kim et al., describe an online publication 40 | PART I - CHAPTER 3 3