{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,26]],"date-time":"2026-10-26T22:00:00Z","timestamp":1793052000617,"version":"4.5.0"},"reference-count":22,"publisher":"BMJ","issue":"7","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2015,5,12]]},"published-print":{"date-parts":[[2015,6]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To identify patterns in euthanasia requests and practices relating to psychiatric patients; to generate recommendations for future research.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Retrospective analysis of data obtained through medical file review.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>Outpatient psychiatric clinical setting in the Dutch-speaking region of Belgium, between October 2007 and December 2011; follow-up at the end of December 2012.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>100 consecutive psychiatric patients requesting euthanasia based on psychological suffering associated with psychiatric disorders (77 women, 23 men; mean age 47\u2005years; age range 21\u201380\u2005years).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Main outcome measures<\/jats:title>\n                    <jats:p>Patient sociodemographic characteristics; diagnoses; decisions on euthanasia requests; circumstances of euthanasia procedures; patient outcomes at follow-up.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Most patients had been referred for psychiatric counselling by their physician (n=55) or by LEIF (Life End Information Forum) (n=36). 90 patients had &gt;1 disorder; the most frequent diagnoses were depression (n=58) and personality disorder (n=50). 38 patients required further testing and\/or treatment, including 13 specifically tested for autism spectrum disorder (ASD); 12 received an ASD diagnosis (all Asperger syndrome). In total, 48 of the euthanasia requests were accepted and 35 were carried out. Of the 13 remaining patients whose requests were accepted, 8 postponed or cancelled the procedure, because simply having this option gave them enough peace of mind to continue living. In December 2012, 43 patients had died, including 35 by euthanasia; others died by suicide (6), palliative sedation (1) and anorexia nervosa (1).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Depression and personality disorders are the most common diagnoses in psychiatric patients requesting euthanasia, with Asperger syndrome representing a neglected disease burden. Further research is needed, especially prospective quantitative and qualitative studies, to obtain a better understanding of patients with psychiatric disorders who request euthanasia due to unbearable psychological suffering.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2014-007454","type":"journal-article","created":{"date-parts":[[2015,7,27]],"date-time":"2015-07-27T20:49:09Z","timestamp":1438030149000},"page":"e007454","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":136,"title":["Euthanasia requests, procedures and outcomes for 100 Belgian patients suffering from psychiatric disorders: a retrospective, descriptive study"],"prefix":"10.1136","volume":"5","author":[{"given":"Lieve","family":"Thienpont","sequence":"first","affiliation":[{"name":"University Hospital Brussels, Brussels, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Monica","family":"Verhofstadt","sequence":"additional","affiliation":[{"name":"MSc student at the Open University of the Netherlands, Heerlen, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tony","family":"Van Loon","sequence":"additional","affiliation":[{"name":"Free University of Brussels, Brussels, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wim","family":"Distelmans","sequence":"additional","affiliation":[{"name":"Free University of Brussels, Brussels, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kurt","family":"Audenaert","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, Ghent University Hospital, Ghent, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter P","family":"De Deyn","sequence":"additional","affiliation":[{"name":"University of Antwerp, Institute Born-Bunge, Wilrijk, Belgium"},{"name":"University of Groningen, University Medical Center Groningen, Groningen, The Netherlands"},{"name":"Middelheim General Hospital, ZNA, Antwerp, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2015,7,27]]},"reference":[{"key":"2025101813450240000_5.7.e007454.1","unstructured":"Ministry of Justice. Law on euthanasia of May 28, 2002. Brussels: Belgian Official Gazette, 2002. http:\/\/www.npzl.be\/files\/107a_B3_Wet_euthanasie.pdf (in Dutch and French)."},{"key":"2025101813450240000_5.7.e007454.2","doi-asserted-by":"publisher","DOI":"10.1016\/j.psym.2012.03.005"},{"key":"2025101813450240000_5.7.e007454.3","doi-asserted-by":"crossref","first-page":"73","DOI":"10.2143\/EP.9.2.503847","article-title":"Euthanasia in the low countries. A comparative analysis of the law regarding euthanasia in Belgium and the Netherlands","volume":"9","author":"Nys","year":"2002","journal-title":"Ethical Perspect"},{"key":"2025101813450240000_5.7.e007454.4","doi-asserted-by":"publisher","DOI":"10.1186\/1472-6963-9-220"},{"key":"2025101813450240000_5.7.e007454.5","doi-asserted-by":"publisher","DOI":"10.1097\/MLR.0b013e3181bd4dde"},{"key":"2025101813450240000_5.7.e007454.6","unstructured":"Delbeke E . Legal aspects of care at the end of life. Antwerp: Intersentia, 2012 (in Dutch)."},{"key":"2025101813450240000_5.7.e007454.7","unstructured":"Tholen AJ , Berghmans RLP , Huisman J , et al . Guideline dealing with the request for assisted suicide by patients with a psychiatric disorder. Utrecht: Dutch Psychiatric Association. De Tijdsstroom, 2009. http:\/\/steungroeppsychiaters.nl\/wp-content\/uploads\/Richtlijn-hulp-bij-zelfdoding_NVvP-2009.pdf (in Dutch)."},{"key":"2025101813450240000_5.7.e007454.8","doi-asserted-by":"crossref","unstructured":"Pans E . (2012). The normative context of the Dutch Euthanasia law. Nijmegen: Wolf legal Publishers, 2006 (in Dutch).","DOI":"10.1017\/CBO9780511843976.008"},{"key":"2025101813450240000_5.7.e007454.9","unstructured":"Griffiths J , Weyers HAM , Adams M . Euthanasia and law in Europe. Oxford, UK; Portland (OR): Hart Publishing, 2008."},{"key":"2025101813450240000_5.7.e007454.10","doi-asserted-by":"publisher","DOI":"10.1136\/jme.2008.026799"},{"key":"2025101813450240000_5.7.e007454.11","unstructured":"Ministry of Justice. Law amending the Law on Euthanasia of May 2002 in order to allow euthanasia for minors. Brussels: Belgian Official Gazette, 2014. http:\/\/www.ejustice.just.fgov.be\/doc\/rech_n.htm (in Dutch)."},{"key":"2025101813450240000_5.7.e007454.12","unstructured":"Federal Control and Evaluation Committee on Euthanasia. Second report to the Parliament (2004\u20132005). Brussels: Federal Control and Evaluation Committee on Euthanasia, 2006. http:\/\/www.dekamer.be\/FLWB\/PDF\/51\/2733\/51K2733001.pdf (in Dutch)."},{"key":"2025101813450240000_5.7.e007454.13","unstructured":"Federal Control and Evaluation Committee on Euthanasia. Fourth report to the Parliament (2008\u20132009). Brussels: Federal Control and Evaluation Committee on Euthanasia, 2010. http:\/\/www.ieb-eib.org\/nl\/pdf\/rapport-euthanasie-2010-belgique-nl.pdf (in Dutch)."},{"key":"2025101813450240000_5.7.e007454.14","unstructured":"Federal Control and Evaluation Committee on Euthanasia. Fifth report to the Parliament (2010\u20132011). Brussels: Federal Control and Evaluation Committee on Euthanasia, 2012. http:\/\/www.senate.be\/www\/webdriver?MItabObj=pdf&MIcolObj=pdf&MInamObj=pdfid&MItypeObj=application\/pdf&MIvalObj=83889004 (in Dutch and French)."},{"key":"2025101813450240000_5.7.e007454.15","first-page":"S222","article-title":"Life End Information Forum (LEIF): professional advice and support at end-of-life issues","volume":"17","author":"Distelmans","year":"2008","journal-title":"Psychooncology"},{"key":"2025101813450240000_5.7.e007454.16","doi-asserted-by":"publisher","DOI":"10.1177\/0269216312463259"},{"key":"2025101813450240000_5.7.e007454.17","first-page":"1065","article-title":"Suffering and euthanasia: a qualitative study of dying cancer patients\u2019 perspectives","volume":"20","author":"Karlsson","year":"2011","journal-title":"Support Care Cancer"},{"key":"2025101813450240000_5.7.e007454.18","doi-asserted-by":"publisher","DOI":"10.1016\/j.euroneuro.2011.07.018"},{"key":"2025101813450240000_5.7.e007454.19","doi-asserted-by":"publisher","DOI":"10.1017\/S0033291701004913"},{"key":"2025101813450240000_5.7.e007454.20","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2013-003320"},{"key":"2025101813450240000_5.7.e007454.21","doi-asserted-by":"crossref","first-page":"256","DOI":"10.4103\/0019-5545.117145","article-title":"Bereavement after the suicide of a significant other","volume":"55","author":"Pompili","year":"2013","journal-title":"Indian J Psychiatry"},{"key":"2025101813450240000_5.7.e007454.22","doi-asserted-by":"crossref","first-page":"339","DOI":"10.1002\/pon.1612","article-title":"Unbearable suffering of patients with a request for euthanasia or physician-assisted suicide: an integrative review","volume":"19","author":"Dees","year":"2009","journal-title":"Psychooncology"}],"container-title":["BMJ Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bmjopen-2014-007454","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,18]],"date-time":"2025-10-18T20:45:09Z","timestamp":1760820309000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmjopen.bmj.com\/lookup\/doi\/10.1136\/bmjopen-2014-007454"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2015,6]]},"references-count":22,"journal-issue":{"issue":"7","published-online":{"date-parts":[[2015,7,27]]},"published-print":{"date-parts":[[2015,6]]}},"alternative-id":["10.1136\/bmjopen-2014-007454"],"URL":"https:\/\/doi.org\/10.1136\/bmjopen-2014-007454","relation":{},"ISSN":["2044-6055","2044-6055"],"issn-type":[{"value":"2044-6055","type":"print"},{"value":"2044-6055","type":"electronic"}],"subject":[],"published":{"date-parts":[[2015,6]]}}}