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Euthanasia and assisted suicide in patients with personality disorders : a review of current practice and challenges. / Mehlum, Lars; Schmahl, Christian; Berens, Ann; Doering, Stephan; Hutsebaut, Joost; Kaera, Andres; Kramer, Ueli; Moran, Paul Anthony; Renneberg, Babette; Ribaudi, Joaquim Soler; Simonsen, Sebastian; Swales, Michaela; Taubner, Svenja; di Giacomo, Ester.

In: Borderline Personality Disorder and Emotion Dysregulation, Vol. 7, No. 1, 15, 30.07.2020.

Research output: Contribution to journalArticle

HarvardHarvard

Mehlum, L, Schmahl, C, Berens, A, Doering, S, Hutsebaut, J, Kaera, A, Kramer, U, Moran, PA, Renneberg, B, Ribaudi, JS, Simonsen, S, Swales, M, Taubner, S & di Giacomo, E 2020, 'Euthanasia and assisted suicide in patients with personality disorders: a review of current practice and challenges', Borderline Personality Disorder and Emotion Dysregulation, vol. 7, no. 1, 15. https://doi.org/10.1186/s40479-020-00131-9

APA

Mehlum, L., Schmahl, C., Berens, A., Doering, S., Hutsebaut, J., Kaera, A., Kramer, U., Moran, P. A., Renneberg, B., Ribaudi, J. S., Simonsen, S., Swales, M., Taubner, S., & di Giacomo, E. (2020). Euthanasia and assisted suicide in patients with personality disorders: a review of current practice and challenges. Borderline Personality Disorder and Emotion Dysregulation, 7(1), [15]. https://doi.org/10.1186/s40479-020-00131-9

CBE

Mehlum L, Schmahl C, Berens A, Doering S, Hutsebaut J, Kaera A, Kramer U, Moran PA, Renneberg B, Ribaudi JS, Simonsen S, Swales M, Taubner S, di Giacomo E. 2020. Euthanasia and assisted suicide in patients with personality disorders: a review of current practice and challenges. Borderline Personality Disorder and Emotion Dysregulation. 7(1):Article 15. https://doi.org/10.1186/s40479-020-00131-9

MLA

VancouverVancouver

Mehlum L, Schmahl C, Berens A, Doering S, Hutsebaut J, Kaera A et al. Euthanasia and assisted suicide in patients with personality disorders: a review of current practice and challenges. Borderline Personality Disorder and Emotion Dysregulation. 2020 Jul 30;7(1). 15. https://doi.org/10.1186/s40479-020-00131-9

Author

Mehlum, Lars ; Schmahl, Christian ; Berens, Ann ; Doering, Stephan ; Hutsebaut, Joost ; Kaera, Andres ; Kramer, Ueli ; Moran, Paul Anthony ; Renneberg, Babette ; Ribaudi, Joaquim Soler ; Simonsen, Sebastian ; Swales, Michaela ; Taubner, Svenja ; di Giacomo, Ester. / Euthanasia and assisted suicide in patients with personality disorders : a review of current practice and challenges. In: Borderline Personality Disorder and Emotion Dysregulation. 2020 ; Vol. 7, No. 1.

RIS

TY - JOUR

T1 - Euthanasia and assisted suicide in patients with personality disorders

T2 - a review of current practice and challenges

AU - Mehlum, Lars

AU - Schmahl, Christian

AU - Berens, Ann

AU - Doering, Stephan

AU - Hutsebaut, Joost

AU - Kaera, Andres

AU - Kramer, Ueli

AU - Moran, Paul Anthony

AU - Renneberg, Babette

AU - Ribaudi, Joaquim Soler

AU - Simonsen, Sebastian

AU - Swales, Michaela

AU - Taubner, Svenja

AU - di Giacomo, Ester

N1 - © The Author(s) 2020.

PY - 2020/7/30

Y1 - 2020/7/30

N2 - Background: Over the last two decades an increasing number of countries have legalized euthanasia and physician-assisted suicide (EAS) leading to considerable debate over the inherent ethical dilemmas. Increasing numbers of people with personality disorders, faced with unbearable suffering, have requested and received assistance in terminating their lives. EAS in people with personality disorders has, however, received very sparse attention from clinicians and researchers. In this paper, we examine the literature on the practice and prevalence of EAS in people with personality disorders to date and discuss the associated challenges for research and practice.Methods: Narrative review of the literature combined with the authors' collective experience and knowledge of personality disorders.Results: In six of the eight countries where EAS is currently legal, mental disorders are accepted as disorders for which EAS may be granted. In four of these countries, EAS in minors with mental disorders is also accepted. Our literature search resulted in 9 papers on the subject of EAS in people with personality disorders. These studies suggest that most clinicians who grant EAS have indeed perceived their patients' suffering as chronic, unbearable and untreatable without prospect of improvement. The majority of patients with personality disorders had tried some form of psychotherapy, but very few had received any of the relevant evidence-based treatments. The decision to grant EAS based on a perception of the patient's illness as being untreatable with no prospect of improvement, could, thus, in many cases fail to meet the due care criteria listed in EAS laws. People with personality disorders more often wish for death for extended periods of time than people without these disorders. However, there is ample empirical data to show that suicidal tendencies and behaviour can be treated and that they fluctuate rapidly over time.Conclusions: In light of our findings, we believe that the current legislation and practice of EAS for people with personality disorders is based on an inadequate understanding of underlying psychopathology and a lack of awareness about the contemporary treatment literature. Moreover, we assert that this practice neglects the individual's potential for having a life worth living.

AB - Background: Over the last two decades an increasing number of countries have legalized euthanasia and physician-assisted suicide (EAS) leading to considerable debate over the inherent ethical dilemmas. Increasing numbers of people with personality disorders, faced with unbearable suffering, have requested and received assistance in terminating their lives. EAS in people with personality disorders has, however, received very sparse attention from clinicians and researchers. In this paper, we examine the literature on the practice and prevalence of EAS in people with personality disorders to date and discuss the associated challenges for research and practice.Methods: Narrative review of the literature combined with the authors' collective experience and knowledge of personality disorders.Results: In six of the eight countries where EAS is currently legal, mental disorders are accepted as disorders for which EAS may be granted. In four of these countries, EAS in minors with mental disorders is also accepted. Our literature search resulted in 9 papers on the subject of EAS in people with personality disorders. These studies suggest that most clinicians who grant EAS have indeed perceived their patients' suffering as chronic, unbearable and untreatable without prospect of improvement. The majority of patients with personality disorders had tried some form of psychotherapy, but very few had received any of the relevant evidence-based treatments. The decision to grant EAS based on a perception of the patient's illness as being untreatable with no prospect of improvement, could, thus, in many cases fail to meet the due care criteria listed in EAS laws. People with personality disorders more often wish for death for extended periods of time than people without these disorders. However, there is ample empirical data to show that suicidal tendencies and behaviour can be treated and that they fluctuate rapidly over time.Conclusions: In light of our findings, we believe that the current legislation and practice of EAS for people with personality disorders is based on an inadequate understanding of underlying psychopathology and a lack of awareness about the contemporary treatment literature. Moreover, we assert that this practice neglects the individual's potential for having a life worth living.

KW - Euthanasia

KW - Personality disorder

KW - Physician-assisted suicide

U2 - 10.1186/s40479-020-00131-9

DO - 10.1186/s40479-020-00131-9

M3 - Article

C2 - 32742662

VL - 7

JO - Borderline Personality Disorder and Emotion Dysregulation

JF - Borderline Personality Disorder and Emotion Dysregulation

SN - 2051-6673

IS - 1

M1 - 15

ER -