{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T09:56:21Z","timestamp":1790675781218,"version":"4.1.0"},"reference-count":48,"publisher":"Cambridge University Press (CUP)","issue":"4","license":[{"start":{"date-parts":[[2019,3,4]],"date-time":"2019-03-04T00:00:00Z","timestamp":1551657600000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/www.cambridge.org\/core\/terms"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Psychol. Med."],"published-print":{"date-parts":[[2020,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec id=\"S0033291719000333_sec_a1\" sec-type=\"other\"><jats:title>Background<\/jats:title><jats:p>Euthanasia or assisted suicide (EAS) for psychiatric disorders, legal in some countries, remains controversial. Personality disorders are common in psychiatric EAS. They often cause a sense of irremediable suffering and engender complex patient\u2013clinician interactions, both of which could complicate EAS evaluations.<\/jats:p><\/jats:sec><jats:sec id=\"S0033291719000333_sec_a2\" sec-type=\"methods\"><jats:title>Methods<\/jats:title><jats:p>We conducted a directed-content analysis of all psychiatric EAS cases involving personality and related disorders published by the Dutch regional euthanasia review committees (<jats:italic>N<\/jats:italic> = 74, from 2011 to October 2017).<\/jats:p><\/jats:sec><jats:sec id=\"S0033291719000333_sec_a3\" sec-type=\"results\"><jats:title>Results<\/jats:title><jats:p>Most patients were women (76%, <jats:italic>n<\/jats:italic> = 52), often with long, complex clinical histories: 62% had physical comorbidities, 97% had at least one, and 70% had two or more psychiatric comorbidities. They often had a history of suicide attempts (47%), self-harming behavior (27%), and trauma (36%). In 46%, a previous EAS request had been refused. Past psychiatric treatments varied: e.g. hospitalization and psychotherapy were not tried in 27% and 28%, respectively. In 50%, the physician managing their EAS were new to them, a third (36%) did not have a treating psychiatrist at the time of EAS request, and most physicians performing EAS were non-psychiatrists (70%) relying on cross-sectional psychiatric evaluations focusing on EAS eligibility, not treatment. Physicians evaluating such patients appear to be especially emotionally affected compared with when personality disorders are not present.<\/jats:p><\/jats:sec><jats:sec id=\"S0033291719000333_sec_a4\" sec-type=\"conclusions\"><jats:title>Conclusions<\/jats:title><jats:p>The EAS evaluation of persons with personality disorders may be challenging and emotionally complex for their evaluators who are often non-psychiatrists. These factors could influence the interpretation of EAS requirements of irremediability, raising issues that merit further discussion and research.<\/jats:p><\/jats:sec>","DOI":"10.1017\/s0033291719000333","type":"journal-article","created":{"date-parts":[[2019,3,4]],"date-time":"2019-03-04T10:28:50Z","timestamp":1551695330000},"page":"575-582","source":"Crossref","is-referenced-by-count":46,"title":["Euthanasia and assisted suicide of persons with psychiatric disorders: the challenge of personality disorders"],"prefix":"10.1017","volume":"50","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1111-4372","authenticated-orcid":false,"given":"Marie E.","family":"Nicolini","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John R.","family":"Peteet","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"G. Kevin","family":"Donovan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Scott Y. H.","family":"Kim","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"56","published-online":{"date-parts":[[2019,3,4]]},"reference":[{"key":"S0033291719000333_ref15","doi-asserted-by":"publisher","DOI":"10.1016\/j.genhosppsych.2004.02.004"},{"key":"S0033291719000333_ref29","unstructured":"Onwuteaka-Philipsen, B , Legemaate, J , van der Heide, A , van Delden, H , Evenblij, K , El Hammoud, I , Pasman, R , Ploem, C , Pronk, R , van de Vathorst, S and Willems, D (2017) Derde evaluatie Wet toetsing levensbe\u00ebindiging op verzoek en hulp bij zelfdoding. 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