[Symposium 88] Euthanasia and Mental Illness: Ethical Dilemmas at the Intersection of Suicide Prevention and Rights Protection

[SY-88] Euthanasia and Mental Illness: Ethical Dilemmas at the Intersection of Suicide Prevention and Rights Protection

Itsuo Asai¹, Yumi Matsumura², Norichika Horie³, Sonu Gaind⁴, Stephanie SJWM Leijten⁵ (1.Heart Clinic Medical Corporation(Japan), 2.Kyoto University(Japan), 3.University of Tokyo,(Japan), 4.University of Toronto(Canada), 5.GGZ Oostbrabant(Netherlands))

Keywords:

Euthanasia,Mental Disorders,Suicide Prevention,Patient Rights,Ethics

This symposium explores the complex ethical, clinical, and societal dilemmas that arise where suicide prevention intersects with the right to die, particularly in the context of psychiatric euthanasia. It confronts the paradox that while suicide among individuals with mental illness is broadly prevented, euthanasia for physical illness is increasingly legalized.Dr. Itsuo Asai (Heart Clinic Medical Corporation, Japan) will open the session with a brief comparative overview of DNR (Do Not Resuscitate) policies and legal frameworks for euthanasia in physical and psychiatric illness, highlighting global disparities and key ethical tensions.Professor Yumi Matsumura (Kyoto University, Japan) will present a clinical case encountered in ethics consultation, illustrating Japan’s limited engagement with euthanasia and associated cultural and institutional constraints.Professor Norichika Horie (University of Tokyo, Japan) will share data from an online survey revealing a strong correlation between depressive symptoms and support for euthanasia, raising questions of vulnerability and informed consent.Professor Sonu Gaind (University of Toronto, Canada) will critically examine Canada’s delayed expansion of Medical Assistance in Dying (MAiD) to psychiatric disorders, emphasizing the particular difficulty in assessing irreversibility and long-term prognosis in mental illness, compared to physical conditions. He will also discuss the influence of social risk factors, oversight limitations, and equity concerns.Finally, Professor Stephanie SJWM Leijten (GGZ Oostbrabant, Netherlands), a member of the euthanasia committee of the NvVP (Dutch Association for psychiatry) , will present an in-depth analysis of the Netherlands’ psychiatric euthanasia system, including procedural safeguards, clinical criteria, and ongoing ethical debates informed by over two decades of practice.This symposium aims to foster international dialogue on reconciling suicide prevention with respect for patient autonomy and human rights in mental health care.