Acceptability of Assisted Suicide in Patients With Severe and Persistent Mental Illness

GeroPsych ◽  
2020 ◽  
pp. 1-8
Author(s):  
Sophie Gloeckler ◽  
Manuel Trachsel
Keyword(s):  
Mental Illness ◽  
Pilot Study ◽  
Psychiatric Diagnosis ◽  
Assisted Suicide ◽  
Shared Values ◽  
Psychiatric Nurses ◽  
Attitudes And Beliefs ◽  
Future Studies ◽  
Persistent Mental Illness ◽  
Moral Attitudes

Abstract. In Switzerland, assisted suicide (AS) may be granted on the basis of a psychiatric diagnosis. This pilot study explored the moral attitudes and beliefs of nurses regarding these practices through a quantitative survey of 38 psychiatric nurses. The pilot study, which serves to inform hypothesis development and future studies, showed that participating nurses supported AS and valued the reduction of suffering in patients with severe persistent mental illness. Findings were compared with those from a previously published study presenting the same questions to psychiatrists. The key differences between nurses’ responses and psychiatrists’ may reflect differences in the burden of responsibility, while similarities might capture shared values worth considering when determining treatment efforts. More information is needed to determine whether these initial findings represent nurses’ views more broadly.

Compliance versus adherence in serious and persistent mental illness

2010 ◽  
Vol 17 (1) ◽  
pp. 77-85 ◽  
Author(s):  
Paula K Vuckovich
Keyword(s):  
Mental Illness ◽  
Mentally Ill ◽  
Psychiatric Nurses ◽  
Ethical Implications ◽  
Persistent Mental Illness ◽  
Term Basis ◽  
Nursing Literature ◽  
Compliance Versus ◽  
The Ideal

Failure to follow prescribed treatment has devastating consequences for those who are seriously and persistently mentally ill. Nurses, therefore, try to get clients to take psychotropic medication on a long-term basis. The goal is either compliance or adherence. Although current nursing literature has abandoned the term compliance because of its implications of coercion, in psychiatric nursing practice with patients suffering from serious long-term mental illness compliance and adherence are in fact different goals. The ideal goal is adherence, which requires the patient to be an active participant in the team. This goal is consistent with nurses’ ethical values, but for such patients this is frequently unrealistic. If the person is severely psychotic, treatment may be involuntary and the goal compliance. Psychiatric nurses participate in involuntary treatment and thus should acknowledge the ethical implications of compliance as a goal and not obscure the issue by calling compliance adherence.

scholarly journals Attitudes toward assisted suicide requests in the context of severe and persistent mental illness: A survey of psychiatrists in Switzerland

2019 ◽  
Vol 17 (6) ◽  
pp. 621-627 ◽  
Author(s):  
Martina A. Hodel ◽  
Paul Hoff ◽  
Scott A. Irwin ◽  
Nikola Biller-Andorno ◽  
Florian Riese ◽  
...  
Keyword(s):  
Mental Illness ◽  
Anorexia Nervosa ◽  
Assisted Suicide ◽  
Psychiatric Patients ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Refractory Depression ◽  
Persistent Mental Illness ◽  
German Speaking ◽  
Case Vignettes

AbstractObjectiveSwitzerland is among the few countries worldwide where a request for assisted suicide (AS) can be granted on the basis of a primary psychiatric diagnosis. Psychiatrists play an increasingly important role in this regard, especially when the request for AS arises in the context of suffering caused by severe and persistent mental illness (SPMI). The objective of the survey was to assess general attitudes among psychiatrists in Switzerland regarding AS requests from patients with SPMI.MethodIn a cross-sectional survey of 1,311 German-speaking psychiatrists in Switzerland, participants were asked about their attitude to AS for patients with SPMI, based on three case vignettes of patients diagnosed with anorexia nervosa, treatment-refractory depression, or severe persistent schizophrenia.ResultFrom a final sample of 457 psychiatrists (a response rate of 34.9%) whose mean age was 57.8 years, 48.6% of respondents did not support access to AS for persons diagnosed with SPMI, 21.2% were neutral, and 29.3% indicated some degree of support for access. In relation to the case vignettes, a slightly higher percentage of respondents supported the patient's wish to seek AS: 35.4% for those diagnosed with anorexia nervosa, 32.1% for those diagnosed with depression, and 31.4% for those diagnosed with schizophrenia.Significance of resultsAlthough a majority of the responding psychiatrists did not support AS for SPMI patients, about one-third would have supported the wishes of patients in the case vignettes. In light of the increasing number of psychiatric patients seeking AS and the continuing liberalization of AS practices, it is important to understand and take account of psychiatrists’ perspectives.

scholarly journals Palliative Psychiatry for Patients with Severe and Persistent Mental Illness: A Survey on the Attitudes of Psychiatrists in India compared to Psychiatrists in Switzerland

2021 ◽  
Author(s):  
Julia Stoll ◽  
Anju Mathew ◽  
Chitra Venkateswaran ◽  
Anil Prabhakaran ◽  
Anna Lisa Westermair ◽  
...  
Keyword(s):  
Mental Illness ◽  
Online Survey ◽  
Previous Survey ◽  
Major Depressive ◽  
Optimal Care ◽  
New Approach ◽  
Future Studies ◽  
Persistent Mental Illness ◽  
Recurrent Major Depressive Disorder

Abstract Background Palliative psychiatry is a new approach for the care of patients with severe and persistent mental illness (SPMI). To assess the attitudes of psychiatrists in India towards palliative psychiatry for patients with SPMI and to compare these to the attitudes of psychiatrists in Switzerland. Methods In an online survey, data from 206 psychiatrists in India were collected and compared with data from a previous survey among 457 psychiatrists in Switzerland. Results Psychiatrists in India generally considered it very important to prevent suicide in SPMI patients (97.6%). At the same time, they considered it very important to reduce suffering (98.1%) and to ensure functionality in everyday life (95.6%). They agreed that palliative psychiatry is important for providing optimal care to SPMI patients without life-limiting illness (79.6%) and considered palliative psychiatry as indicated for patients with SPMI (78.2%). By contrast, curing the illness was considered very important by only 39.8 % of respondents. Relative to psychiatrists in Switzerland, psychiatrists in India were significantly more concerned about preventing suicide and less willing to accept a reduction in life expectancy, even at the expense of quality of life in patients with severe and persistent schizophrenia and recurrent major depressive disorder. At the same time, they were significantly more likely to advocate palliative psychiatry. Conclusion Most of the participating psychiatrists in India agreed that palliative psychiatry can be indicated for patients with SPMI. The comparison with psychiatrists in Switzerland highlights the need to take account of cultural differences in future studies of this kind.

A Walking Program for Outpatients in Psychiatric Rehabilitation: Pilot Study

2005 ◽  
Vol 7 (2) ◽  
pp. 87-97 ◽  
Author(s):  
Judith McDevitt ◽  
JoEllen Wilbur ◽  
Joseph Kogan ◽  
Joan Briller
Keyword(s):  
Heart Rate ◽  
Mental Illness ◽  
Pilot Study ◽  
Psychosocial Functioning ◽  
Decisional Balance ◽  
Moderate Intensity ◽  
Target Heart Rate ◽  
Cardiovascular Risk Reduction ◽  
Persistent Mental Illness ◽  
Walking Program

The purposes of this quasi-experimental pilot study were to determine adherence to a 12-week group-based moderate-intensity walking program for sedentary adult outpatients with serious and persistent mental illness and to examine change from baseline to after the walking program in health status (mental and physical health, mood, and psychosocial functioning) and exercise motivation (exercise outcomes expectancies, exercise decisional balance). The 15 volunteers in this study were aged 21 to 65 years and enrolled in psychosocial rehabilitation; they participated in a 12-week walking program meeting three times per week for 1 hr, supplemented with four health information workshops delivered at the beginning of the study. Participants received individual exercise prescriptions determined by preprogram fitness testing and used heart rate monitors during walking sessions. Thirteen participants (87%) completed the study and attended 76% of the walking sessions. Overall, they walked at lower intensity than prescribed, with pulses within target heart rate ranges 35% of the time during Weeks 1 through 4, 26% of the time during Weeks 5 through 8, and 22% of the time during Weeks 9 through 12. However, mood improved (Profile of Mood States, t = -2.51, two-tailed, df = 12, p = .02), as did psychosocial functioning (Multnomah Community Ability Scale, two-tailed, df = 12, t = 2.49, p = .02). The findings indicate a walking group may be feasible for rehabilitation programs. In addition to the known cardiovascular risk-reduction benefits of regular walking, walking may improve mood and psychosocial functioning in adults with serious and persistent mental illness.

Crisis Occurrence and Resolution in Patients with Severe and Persistent Mental Illness

Crisis ◽  
2005 ◽  
Vol 26 (4) ◽  
pp. 160-169 ◽  
Author(s):  
Paul S. Links ◽  
Rahel Eynan ◽  
Jeffrey S. Ball ◽  
Aiala Barr ◽  
Sean Rourke
Keyword(s):  
Mental Illness ◽  
Suicide Ideation ◽  
Rating Scale ◽  
Psychiatric Symptoms ◽  
Self Report ◽  
Community Treatment ◽  
Persistent Mental Illness ◽  
Crisis Events ◽  
Symptom Distress Scale ◽  
Distress Scale

Abstract. Assertive community treatment appears to have limited impact on the risk of suicide in persons with severe and persistent mental illness (SPMI). This exploratory prospective study attempts to understand this observation by studying the contribution of suicidality to the occurrence of crisis events in patients with SPMI. Specifically, an observer-rated measure of the need for hospitalization, the Crisis Triage Rating Scale, was completed at baseline, crisis occurrence, and resolution to determine how much the level of suicidality contributed to the deemed level of crisis. Second, observer-ratings of suicidal ideation, the Modified Scale for Suicide Ideation, and psychopathology and suicidality, Brief Psychiatric Rating Scale, were measured at baseline, crisis occurrence, and resolution. A self-report measure of distress, the Symptom Distress Scale, was completed at baseline, crisis occurrence, and resolution. Finally, the patients' crisis experiences were recorded qualitatively to compare with quantitative measures of suicidality. Almost 40% of the subjects experienced crisis events and more than a quarter of these events were judged to be severe enough to warrant the need for hospitalization. Our findings suggest that elevation of psychiatric symptoms is a major contributor to the crisis occurrences of individuals with SPMI; although the risk of suicide may have to be conceived as somewhat separate from crisis occurrence.

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