CCHR insists legalized physician assisted-suicides of psychiatric patients in European countries and Canada should not be adopted in the U.S. and other countries. On one hand, patients are involuntarily committed for suicidal behavior and on the other, they can be legally killed when treatment fails them.

By Jan Eastgate
President, CCHR International
August 23, 2021

Citizens Commission on Human Rights warns against a potentially dangerous trend that the U.S. could follow—allowing the legal killing of mental health patients. Hundreds have died in Europe already in legalized assisted-suicides. Eight states (CA, CO, HI, ME, NJ, OR, VT, and WA) and DC have legalized physician-assisted suicide (PAS).[1] While the U.S. limits this to terminally ill individuals, CCHR says it’s a quick jump from this to killing patients who do not have terminal illnesses but are suffering as emotional, not physical disabilities after failed psychiatric treatments.

Take Canada as an example, where legalized euthanasia was enacted in 2016. But this year, a Senator, who is also a psychiatrist, declared that excluding individuals with psychiatric disorders from being euthanized was “discriminatory.” The law now allows mental health patients to be euthanized, which goes into effect in two years.[2]

Since 2002, Belgium, the Netherlands, and Luxembourg have had laws that allow psychiatric patients who are suicidal to voluntarily receive death by lethal injection (euthanasia) or a self-administered prescription for lethal medication (assisted suicide). Between 100 and 200 psychiatric patients are euthanized annually between Belgium and the Netherlands, The Psychiatric Times reported.[3]

According to Professor Willem Lemmens of the University of Antwerp, requests for euthanasia in psychiatry became more and more acceptable and common in Belgium, but allowing euthanasia to become an option for often-suicidal patients is a “profound” change in the culture.[4]

“Psychiatrists and mental health professionals are precisely the kind of persons those who are suicidal might go to for help. The shift to suicide assistance, by the very people whose role we customarily think of as being suicide prevention, is one that will…alarm many,” said Michael Wee, the education officer at the Oxford-based Anscombe Bioethics Centre.[5]

In the past, many U.S. states had laws that regarded the act of suicide as a felony, although these were seldom enforced.[6]  This changed to incarcerating people who were suicidal in psychiatric institutions where, stripped of all rights, they were forcibly drugged and electroshocked to prevent further attempts. This practice still occurs today, despite its failure and condemnation by United Nations human rights and anti-torture groups. The grounds for involuntarily detaining patients rest largely on the psychiatric opinion that they are a “danger to themselves or others.”

Were Europe and Canada’s trends to be adopted here and in Australia, after forced psychiatric hospitalization and treatment fail, the desperate state patients are left in means suicidal behavior would no longer constitute a danger, but would be grounds for psychiatrists to euthanize them—a shift from “suicide prevention” to “suicide assistance.”

In the late eighties and early nineties, the newer antidepressants were to be the miracle pills to reduce suicides. However, suicides started to climb.[7]

In 2004, the Food and Drug Administration confirmed with a black box warning that the drugs could cause suicide, minimally up to the age of 24.

But a 2016 review of clinical trial data published by the Royal Society of Medicine determined the suicide risk from antidepressants is also evident in those older than 24, stating: “antidepressants double the occurrence of events in adult healthy volunteers that can lead to suicide and violence.”[8]

In 2020, three Australian researchers—Martin Whitely at John Curtin Institute of Public Policy in Perth, Melissa Raven and Jon Jureidini at the University of Adelaide’s Critical and Ethical Mental Health Research Group—studied the increasing adverse impact of antidepressants on suicide, writing: “There is clear evidence that more young Australians are taking antidepressants, and more young Australians are killing themselves and self-harming, often by intentionally overdosing on the very substances that are supposed to help them.”[9]

Prof. David Healy, a leading international psychopharmacologist, and colleagues noted that between 2006 and 2015, 15 clinical trials of antidepressants recruiting more than 6,000 children took place. All were negative and showed an excess of suicidality took place.[10] They also stated the obvious: “Something must surely be wrong if the frequency of depression has apparently jumped a thousand-fold since the introduction of antidepressants.”[11]

The U.S. National Institute of Mental Health (NIMH) reports that as many as two-thirds of those taking antidepressants do not recover from depression, that psychiatrists ignore this as treatment failure, redefining it as “treatment-resistance.”[12] A 2017 study published in Frontiers in Psychiatry concluded that “antidepressants are largely ineffective and potentially harmful.” Lead researcher Michael P. Hengartner at the Zurich University of Applied Sciences in Switzerland cited evidence that the likelihood of relapse is also correlated with treatment duration. That is, the more one takes an antidepressant, the likelier one is to have another episode of depression.[13]

There’s no medical test to show a person’s emotional or behavioral problems or ‘disorder’ physically exist and are terminal. But there is evidence that psychiatric treatment creates harm and fails, which means the more likely it is that patients could get quickly to the point of requesting psychiatrists to legally euthanize them.  This is essentially giving them a license to kill, as there would be no criminal fall back on the doctor.

Women over-represented in psychiatric treatment and subsequent euthanasia. About two-thirds of those who receive electroshock treatment are women. The majority of patients taking antidepressants are also women. Harvard Health Publishing estimates that 1 in 10 women ages 18 and over are on antidepressants.[14] In a 2016 study of psychiatric-assisted suicides in The Netherlands, 70% (46 of 66) of patients were women, 32% were over 70 years-old, 44% were between 50–70, and 24% were 30–50. Most had histories of attempted suicides and psychiatric hospitalizations; 39% (26 patients) had been electroshocked. A majority had “personality disorders” and were described as socially isolated or lonely. Depressive disorders were the primary issue in 55% of cases—with focus on so-called “treatment-resistant depression” rather than examining the abject failure of treatment to help. At least 56% had gotten to the point where they refused treatment that, arguably, had failed to make them feel better about life.[15] A shocking indictment of psychiatric treatment failure.

This move is open to mis-diagnosis when there is no medical science or test to substantiate a psychiatric diagnosis. A Dutch case reported in the BMJ was that of a 68-year-old patient diagnosed with “bipolar I disorder,” with a request for euthanasia because of “tiredness, repeated falls and racing thoughts” (which can be side effect of drugs prescribed). Persisting in her wish, her family and psychiatrist became convinced of the need for euthanasia. But in receiving a second opinion, the woman agreed with discontinuation of psychotropic drugs. Her mobility and tiredness improved and she recovered meaning in her life.[16]

Brian Callister, a practicing U.S. physician and medical school professor says doctors and insurance companies already have incentives to pressure patients to kill themselves. Callister writes: “When insurers and our government are faced with skyrocketing health care costs, PAS gives them the real and inexpensive alternative to deny you care and provide you with a deadly prescription instead. It’s a lot cheaper to give you a bunch of pills to kill you rather than pay to treat you. Sadly, such real abuses are already being witnessed in states where PAS is legal.”[17]

In New South Wales in Australia, a law was introduced called the Voluntary Assisted Dying Bill 2021 to legalize euthanasia, although limited to date to physical terminal illnesses.[18] In the U.S., a recently released Hastings Center Report in Utah, which explores the “ethical, legal, and social issues in medicine,” is advocating the potential for an “advance directive implant” for prospective dementia patients which would allow the person to use a timer-based implant that would kill them automatically without help from anyone else at a date they determine.[19] The implant hasn’t yet been developed but this is the Brave New World to which we are heading.

CCHR is monitoring the advent of all psychiatric-assisted suicide laws and condemns the practice, saying psychiatrists should never have been given such power and the failure of their treatments, with rising suicide rates as a result, should be investigated.

References:

[1] https://euthanasia.procon.org/states-with-legal-physician-assisted-suicide/

[2] https://www.psychiatrictimes.com/view/first-do-no-harm

[3] Ibid.

[4] Charles Collins, “Euthanasia for mental ailments changing ‘suicide prevention’ to ‘suicide assistance,’” Crux, 6 July 2016, https://cruxnow.com/church-in-uk-and-ireland/2018/07/euthanasia-for-mental-ailments-changing-suicide-prevention-to-suicide-assistance/

[5] Ibid.

[6] https://mentalhealthdaily.com/2014/07/24/is-suicide-illegal-suicide-laws-by-country/

[7] “Getting It Right About Antidepressants And A Global Concern About Psychiatric Drug Dependency & Lethal Risks,” CCHR International, 5 Aug. 2019, https://www.cchrint.org/2019/08/05/getting-it-right-about-antidepressants/citing: “Suicide Rates Climb In U.S., Especially Among Adolescent Girls,” NPR, 22 Apr. 2016, https://www.npr.org/sections/health-shots/2016/04/22/474888854/suicide-rates-climb-in-u-s-especially-among-adolescent-girls

[8] Op. cit., CCHR International, 5 Aug. 2019, citing: Andreas Ø Bielefeldt, et al., “Precursors to suicidality and violence on antidepressants: systematic review of trials in adult healthy volunteers,” Journal of the Royal Society of Medicine, October 2016, Vol. 109, No. 10, p. 381, http://jrs.sagepub.com/content/109/10/381.full

[9] “CCHR Hails Australia’s Study Of Antidepressant Link To Youth Suicide,” CCHR International, 15 Dec. 2020, https://www.cchrint.org/2020/12/15/cchr-hails-australias-study-of-antidepressant-link-to-youth-suicide/, citing: “Antidepressant Prescribing and Suicide/Self-Harm by Young Australians: Regulatory Warnings, Contradictory Advice, and Long-Term Trends,” Frontiers in Psychiatry, 5 June 2020, https://www.frontiersin.org/articles/10.3389/fpsyt.2020.00478/full

[10] “Psycho-Pharma Front Groups Paid Million$,” CCHR International, 17 Aug. 2020, https://www.cchrint.org/2020/08/17/psycho-pharma-front-groups-paid-millions/, citing: David Healy, M.D., Joanna Le Noury, Julie Wood, Children of the Cure: Missing Data, Lost Lives and Antidepressants, (Samizdat Health Writer’s Co-operative Inc., 2020), p. 238

[11] Ibid., p. 20

[12] Op. cit., CCHR International, 5 Aug. 2019, citing: “Doctors Are Too Quick to Give Women Antidepressants,” Vice, 27 Jun. 2017, citing: https://www.vice.com/en_us/article/43yjbj/doctors-are-too-quick-to-give-women-antidepressants

[13] Ibid., citing:  Michael P. Hengartner, “Methodological Flaws, Conflicts of Interest, and Scientific Fallacies: Implications for the Evaluation of Antidepressants’ Efficacy and Harm,” Frontiers in Psychiatry, 7 Dec. 2017, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5725408/

[14] Monica Castillo, “Millions of women are taking antidepressants. Why don’t we know their long-term effects?”, The Lilly, 9 Apr. 2018, https://www.thelily.com/millions-of-women-are-taking-antidepressants-why-dont-we-know-their-long-term-effects/

[15] Scott Y. H. Kim et al, “Euthanasia and Assisted Suicide of Patients with Psychiatric Disorders in the Netherlands 2011–2014,” JAMA Psychiatry, Apr. 2016, 73(4): 362–368, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5530592/

[16] Olga Schmahl, et al, “Case report: Request for euthanasia by a psychiatric patient with undetected intellectual disability,” BMJ, Vol 14, Issue 8, 2020, https://casereports.bmj.com/content/14/8/e239862

[17] Sarha Tezzo, “Doctor says assisted suicide leading insurance companies to deny treatments,” Live Action, 21 Feb. 2019, https://www.liveaction.org/news/doctor-assisted-suicide-insurance-deny/

[18] https://dwdnsw.org.au/draft-consultation-voluntary-assisted-dying-bill-released/

[19] https://www.liveaction.org/news/euthanasia-implant-people-dementia/