GESTIÓN EN SALUD PÚBLICA: BioEdge: Belgium: euthanasia doctors split over psychiatric illness

lunes, 30 de octubre de 2017

BioEdge: Belgium: euthanasia doctors split over psychiatric illness

Belgium: euthanasia doctors split over psychiatric illness

by Michael Cook | 28 Oct 2017 | 1 comment

Psychiatrist Dr. Lieve Thienpont, right, speaks with a patient who received approval for euthanasia about a year ago,

Even the controversial head of Belgium’s euthanasia commission is concerned that a well-known Belgian psychiatrist is allowing too many of her psychiatric patients to be euthananised.

Dr Wim Distelmans, an oncologist and the chair of the country’s euthanasia commission has also helped to found a number of end-of-life clinics. He is euthanasia’s most prominent defender in Belgium. However, even he is alarmed at the policies followed by psychiatrist Lieve Thienpont. According to an investigative report by Associated Press, backed up by a leak of confidential documents:

In 2015, Thienpont was the lead author of a paper published in the medical journal BMJ Open, tracking 100 of her patients who requested euthanasia between 2007 and 2011. Of those, 48 were granted.

Some doctors were stunned by the high number of requests Thienpont fielded and how many were approved. At some other major psychiatric centers in Belgium, doctors receive only a handful of such requests every year, of which perhaps about 10 to 30 percent are accepted, according to several psychiatrists who deal with such requests.

“That one single psychiatrist in Belgium has had such a major impact on the practice of euthanasia in psychiatric patients is very alarming,” said Dr. Stephan Claes, a psychiatrist at the University of Leuven.

In a February 13 letter, Distelmans told Thienpont that some of her patients may have been killed without meeting a legal requirement that an independent consultation be performed first.

“Your euthanasia cases will not be treated anymore within our operation. The reason is a difference of opinion on how a request for euthanasia must be approved. We have already communicated this several times orally, but to no avail.”

Distelmans and his colleagues appear to be concerned that Thienpont was filling her psychiatric patients with unrealistic expectations about their requests for euthanasia.

“We found several times that you had already made promises to patients that were referred to us,” they wrote, and that such “promises” undermined their own attempts to engage with patients and figure out if euthanasia was justifiable. “We want to distance ourselves from this way of working.”

Other psychiatrists are trying to draft guidelines which will make it harder for psychiatric patients to access euthanasia. “I’m convinced that in Belgium, people have died where there were still treatment options and where there was still a chance for years and even decades of (quality) life,” Dr Joris Vandenberghe, a psychiatrist at the University of Leuven, told AP.

Sunday, October 29, 2017

Stories like this have surfaced in BioEdge before, but I have always found them quite touching. We report below that researchers have found that a Neanderthal who lived in a large cave in Iraq about 50,000 years ago was terribly handicapped. Not only was he blind in one eye, missing a forearm, and crippled, but he was also profoundly deaf. With Pleistocene lions and tigers prowling in the neighbourhood, this was a big handicap for a forager.

How did he survive? His clan cared for him, tended to his needs, healed his wounds and protected him. He died at the ripe old age of 40 or 50 (equivalent to about 80 nowadays). Obviously Thomas Hobbes' infamous maxim -- that the life of man outside society is "solitary, poor, nasty, brutish, and short" -- needs to be revised. Primitive as they were, these Neanderthals had their own family-based version of Obamacare.