The Moral Compass of Contemporary Health
The moral debate about euthanasia in psychiatry
Philosophy in Action 2.4
Faculty of Health, Medicine and Life Sciences (FHML)
Bachelor Health Sciences – Maastricht University
Author: L.B.A. Eichhorst
Student number: i6158979
Word count: 2447
Date of submission: 8th February 2019
Block code: GZW2224
, Introduction
Nowadays, the term 'euthanasia' regularly appears in the media, and there are various
discussions about this. Various opinions exist in science and society in relation to this subject,
and the articles that are published confirm these differences of opinion. These articles are
published under different titles, such as: “Euthanasia: the debate continues” (Lane &
Dunstan, 1995), “The ‘Right’ to Die: The Case for and against Voluntary Passive
Euthanasia” (Goldberg, 1987). Since 2001, euthanasia and physician-assisted suicide have
been legalized in Dutch legislation (Materstvedt, 2003). Despite the years of discussions
about whether euthanasia is ethically permitted or not, the law around this aspect offers more
and more possibilities. Although previously only patients who had somatic suffering could
request euthanasia, psychiatric patients can also make a request today (Weyers, 2010).
Euthanasia is permitted in both physical and mental health care, provided that the person
concerned is suffering unbearably, the situation is hopeless and the person concerned is
competent (Haarhuis, 2007). However, assessing a request for help with suicide is often
difficult for psychiatric patients; the death wish can also be a symptom of the disorder and the
will ability can be affected by the disease. Guidelines and due diligence requirements are
required in relation to this topic (Tholen, Berghmans, Legemaate, & Nolen, 1999).
Moral debate
Given the introduction, it is self-evident that psychiatrists have an important task with regard
to euthanasia in psychiatric patients; they determine whether a request is being answered. If
the ability and judgment of persons with a mental disorder are examined, it is difficult to
correctly assess a request (Krogt, 2011). What makes assessment so difficult in the case of a
psychiatric patient? A known dilemma for many therapists relates to the fact that competence
and the degree of hopelessness are difficult to assess (Block & Billings, 1995). Research has
shown that the degree of competence can be influenced by having a mental illness. For
example, psychiatric patients seem to have difficulty with adequate action and the application
of the right knowledge and skills (Sadler, Meagor, & Kaye, 2012). In addition, there is
hopelessness if there is no chance of recovery. This hopelessness is difficult to establish
within mental health care because it depends on the subjective experience of the patient
(Beck, Kovacs, & Weissman, 1975). The moral dilemma for mental health professionals
consists of the choice between continuing treatment or euthanasia.
On the one hand, there are a number of reasons for not performing euthanasia. For
example, doctors have the medical oath to improve the situation of a patient and to keep the
