Michelle Dawson posts

Post published on Twitter/X on 23 May 2023 17:52

Twitter/X DOI work crossref Extract quoted in the post External link integrated into the post Autism terms

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23 May 2023 18:00

Note: there are 6 case examples in the Appendix, including "A man of above-average intelligence (aged 18–30) was severely autistic and found this difficult to cope with. His suffering was described as ‘the realisation that he could not lead a “normal” life’"

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Irene Tuffrey-Wijne, Leopold Curfs, Sheila Hollins, Ilora Finlay (2023). Euthanasia and physician-assisted suicide in people with intellectual disabilities and/or autism spectrum disorders: investigation of 39 Dutch case reports (2012–2021). BJPsych Open, 9(3), e87. Royal College of Psychiatrists.

Publication date
23 May 2023
Identifier
10.1192/bjo.2023.69
Authors
Irene Tuffrey-Wijne, Leopold Curfs, Sheila Hollins, Ilora Finlay
Source
BJPsych Open
Details
9(3), e87
Reference type
article
Publisher
Royal College of Psychiatrists
Metadata source
crossref

Abstract

Background Euthanasia review committees (Regionale Toetsingscommissies Euthanasie, RTE) scrutinise all Dutch cases of euthanasia and physician-assisted suicide (EAS) to review whether six legal ‘due care’ criteria are met, including ‘unbearable suffering without prospect of improvement’. There are significant complexities and ethical dilemmas if EAS requests are made by people with intellectual disabilities or autism spectrum disorders (ASD). Aims To describe the characteristics and circumstances of people with intellectual disabilities and/or ASD who were granted their EAS request; investigate the main causes of suffering that led to the EAS request; and examine physicians’ response to the request. Method The online RTE database of 927 EAS case reports (2012–2021) was searched for patients with intellectual disabilities and/or ASD (n = 39). Inductive thematic content analysis was performed on these case reports, using the framework method. Results Factors directly associated with intellectual disability and/or ASD were the sole cause of suffering described in 21% of cases and a major contributing factor in a further 42% of cases. Reasons for the EAS request included social isolation and loneliness (77%), lack of resilience or coping strategies (56%), lack of flexibility (rigid thinking or difficulty adapting to change) (44%) and oversensitivity to stimuli (26%). In one-third of cases, physicians noted there was ‘no prospect of improvement’ as ASD and intellectual disability are not treatable. Conclusions Examination of societal support for suffering associated with lifelong disability, and debates around the acceptability of these factors as reasons for granting EAS, are of international importance.

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