Since its legalisation in 2002, the number of times euthanasia has been carried out in response to requests from adults with psychiatric conditions (APC) has continued to increase. However, little is known about why and how psychiatrists become engaged in the assessment of such euthanasia requests. A cross-sectional survey study was conducted between November 2018 and April 2019 of 499 psychiatrists affiliated with the Flemish Psychiatry Association. Chi square/Fisher’s exact tests were performed to examine if, and to what extent, psychiatrists’ backgrounds relate to their concrete experiences. The answers to the open question regarding motives for (non-) engagement were thematically coded. Two hundred one psychiatrists participated, a response rate of 40%. During their careers, 80% of those responding have been confronted with at least one euthanasia request from an APC patient and 73% have become involved in the assessment procedure. Their engagement was limited to the roles of: referring physician (in 44% of the psychiatrists), attending physician (30%), legally required ‘advising physician’ (22%), and physician participating in the actual administration of the lethal drugs (5%). Within the most recent 12 months of practice, 61% of the respondents have been actively engaged in a euthanasia assessment procedure and 9% have refused at least once to be actively engaged due to their own conscientious objections and/or the complexity of the assessment. The main motive for psychiatrists to engage in euthanasia is the patient’s fundamental right in Belgian law to ask for euthanasia and the psychiatrist’s duty to respect that. The perception that they were sufficiently competent to engage in a euthanasia procedure was greater in psychiatrists who have already had concrete experience in the procedure. Although the majority of psychiatrists have been confronted with euthanasia requests from their APC patients, their engagement is often limited to referring the request to a colleague physician for further assessment. More research is needed to identify the determinants of a psychiatrist’s engagement in euthanasia for their APC patients and to discover the consequences of their non-, or their restricted or full engagement, on both the psychotherapeutic relationship and the course of the euthanasia request.

中文翻译：

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比利时精神科医生参与评估精神病患者的安乐死请求：一项调查研究。

自2002年安乐死合法化以来，应患有精神疾病的成年人（APC）的要求而实施安乐死的次数持续增加。然而，人们对精神科医生为何以及如何参与对此类安乐死请求的评估知之甚少。2018 年 11 月至 2019 年 4 月期间，对佛兰德精神病学协会附属的 499 名精神科医生进行了一项横断面调查研究。卡方/费舍尔的精确测试是为了检查精神科医生的背景是否以及在多大程度上与其具体经历相关。关于（非）参与动机的开放性问题的答案是按主题编码的。201 名精神科医生参与，回应率为 40%。在他们的职业生涯中，80% 的受访者至少遇到过一次 APC 患者的安乐死请求，73% 的人参与了评估程序。他们的参与仅限于以下角色：转诊医生（44% 的精神科医生）、主治医生（30%）、法律要求的“建议医生”（22%）以及参与致命药物实际管理的医生（ 5%）。在最近 12 个月的实践中，61% 的受访者积极参与安乐死评估程序，9% 的受访者由于自己良心上的反对和/或评估的复杂性而至少拒绝一次积极参与。精神科医生实施安乐死的主要动机是比利时法律规定患者享有要求安乐死的基本权利，以及精神科医生有义务尊重这一权利。在安乐死手术方面已经有具体经验的精神科医生更认为自己有足够的能力进行安乐死手术。尽管大多数精神科医生都遇到过 APC 患者的安乐死请求，但他们的参与往往仅限于将请求转交给同事医生进行进一步评估。需要更多的研究来确定精神科医生对 APC 患者实施安乐死的决定因素，并发现他们不参与、限制或充分参与对心理治疗关系和安乐死请求过程的影响。