Medicine, Psychiatry and Euthanasia: an Argument Against Mandatory Psychiatric Review

This paper critically appraises the argument that requests for active assistance to die should be subject to mandatory psychiatric assessment. This intuitively appealing view is challenged through a broader analysis which examines connections between medicine’s traditional adherence to the moral distinction between acts & omissions & the following issues: the historical relationship between medical practice & dying, the recent development of research into treatment-withdrawal decisions, the scientific status of psychiatry, the logic of rationality & decision-making competence. The analysis revealed a number of hitherto unexamined & unacknowledged influences which would make psychiatric review of requests for assisted death a much less objective & impartial process than is assumed. Mandatory psychiatric review is an instance of the medicalization of death & dying which could abridge the freedom of certain individuals to make decisions about their deaths. (53 refs.)