Abstract
The Right to Choose
Highlights
With the increasing legalization of Medical Aid-in-Dying (MAiD) across the world, the question of whether psychiatric patients with refractory mental illness should have access to this health service is a topic of ethical debate
With present-day autonomy encouragement, and the right to die, a psychiatric diagnosis should never automatically preclude a patient from making decisions about their treatment, including the use of MAiD
Perhaps the greatest manifestation of this autonomy is evidenced in the increasing availability of Physician-Assisted Suicide or Medical Aid-in-Dying (MAiD)
Summary
There are three main arguments against allowing a patient with psychiatric suffering to pursue MAiD. The second argument against allowing a patient with psychiatric suffering to pursue MAiD is that suicidality itself can manifest as a common symptom of psychiatric disorders (including major depressive disorder) In this context, a patient with severe mental illness who has requested MAiD, following appropriate treatment, may no longer wish to die. In a survey of 457 psychiatrists in Switzerland – one of the few countries in which MAiD can be granted “on the basis of a primary psychiatric diagnosis,” 29.3 percent of respondents indicated some degree of support for the availability of MAiD to patients with severe and persistent mental illness – an acceptance rate that parallels that of medical providers.[8] Among a profession dedicated to preserving life, there remains much (reasonable) caution about hastening its end
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