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ISPS (the International Society for Psychological and Social Approaches to Psychosis) wants to alert the world to the dangerous evolution of allowing euthanasia or assisted suicide for unbearable mental suffering caused by psychiatric conditions. This raises complex medical, ethical, and societal/political questions that cannot be considered in isolation.

Psychiatric conditions are complex and dynamic, with the potential for change and improvement always present. A strong wish to die is often the result of despair and tunnel vision, not an irreversible prognosis. The role of caregivers is to counter this despair by maintaining hope, openness to alternatives, and a warm, continuous dialogue to understand the underlying issues. Giving up hope undermines the psychiatric profession.

Suicide and euthanasia have a profound impact on the person’s close environment. Autonomy is only possible in connection with others – “real autonomy” does not exist in isolation. Assisted suicide places sole responsibility on one person and leaves loved ones in guilt. Evidence shows no reduction in actual suicide rates in countries where euthanasia is legal.

There are concerning societal/political implications as well. The presence of euthanasia as an option can create subtle or overt pressure on vulnerable patients to choose death. It shifts societal values, normalizing the idea that life is negotiable and no longer inherently valuable. This echoes the past misuse of psychiatry for eugenics and the devaluation of certain lives.

In many countries, years of underinvestment in mental health have limited the choices and support available, leading people to despair. Every person has a human right to good mental health care, not a “right” to euthanasia. Given the stigma surrounding mental illness, the state must not change the ethical code to allow doctors to facilitate harm.

As the founder of the hospice movement, Cicely Saunders said, “if nothing can be done, there is still a lot to do.” Maintaining this core principle of preserving life and human dignity is the kernel question at hand.