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Current controversy
Suicidal behaviour is pathological: implications for psychiatric euthanasia
  1. Dominic Sisti1,
  2. J John Mann2,3,
  3. Maria A Oquendo4
  1. 1Department of Medical Ethics & Health Policy, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA
  2. 2Department of Psychiatry, Columbia University, New York, New York, USA
  3. 3New York State Psychiatric Institute, New York, New York, USA
  4. 4Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA
  1. Correspondence to Dr Dominic Sisti; sistid{at}upenn.edu

Abstract

Some have challenged the validity of labelling suicidal thoughts and behaviours (STB) as pathological. In this paper, we argue that STB is indeed pathological, thereby, situating suicide prevention within the realm of medicine, complicating calls for the legalisation of medical assistance in dying for individuals whose sole condition is psychiatric (psychiatric medical assistance in dying (MAID)). Evidence shows STB predicts the risk of suicide; moreover, several mental illnesses are associated with STB, and 70%–90% of suicide deaths are linked to psychiatric illness. Treating psychiatric illnesses can prevent suicide. We contend that this clinical evidence not only warrants the classification of STB as pathological but also necessitates its treatment and prevention. This perspective poses a challenge to legislation that would legalise psychiatric MAID.

  • Psychiatry
  • Euthanasia
  • Suicide
  • Ethics- Medical
  • Philosophy- Medical

https://doi.org/10.1136/jme-2023-109522

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    Footnotes

    • Contributors Each author equally contributed to manuscript conception, drafting, and revisions. DS is the guarantor of overall content.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.