A study published in the BMC Psychiatric describes regular developments in euthanasia, between 2002 and 2013, for individuals with a psychiatric disorder or suffering from dementia. The EBI comments as follows.
Between 2002 and 2013, "patients with psychiatric disorders and dementia" accounted for 179 "registered" cases, which represent since 2008 "3% of cases of euthanasia". Since 2002 and up until now, the recorded number of cases of euthanasia involving individuals with dementia did not exceed 0.5%.
Amongst these, "46.4% of individuals were suffering solely from depression, 34.6% had dementia, including Alzheimer's disease, 12.3% had other psychiatric disorders and 6.7% presented depression and other psychiatric disorders". The study also showed that "most of the requests came from women: 58.1% for dementia and 77.1% for mood-related disorders".
Belgian law allows "capable and cognizant" individuals making a "voluntary, well thought-out, repeated" request to undergo euthanasia. This request must not "be due to external pressures". The individual in question "must be in an intolerable, incurable state of physical or psychological suffering, with no reasonable alternative and no therapeutic option available to them". To this end, the individual "must know which condition he/she is suffering from and the prognosis in order to make the right decision".
The application of this legislation to individuals with dementia or psychiatric disorders is controversial since "the ability to express a voluntary wish is reduced". The EBI wonders whether the desire to commit suicide could stem from "a symptom of the disorder in question". Such individuals are in an "extremely vulnerable" situation and "death is seldom ‘imminent’". Belgian law requires "a consultation with a second independent doctor prior to euthanasia. In the case of psychiatric disorders, a third medical expert must be consulted" and a period of one month should elapse between the written request and euthanasia.
The EBI deplores "the inevitable amount of confusion" between "genuine, incurable ‘pathological depression’ and depression in patients who feel isolated and beset by age-related health problems or who have to face the loss of their partner" and points out that "euthanasia cannot become the only option for individuals with depression since new treatments are available". The EBI also states that the study inquires "whether legal requirements are genuinely respected". "Clear, universally accessible clinical directives (protocols) must therefore be implemented”.
For further reading: