Van Ham PH, Van Dis H; International Conference on AIDS.
Int Conf AIDS. 1992 Jul 19-24; 8: B177 (abstract no. PoB 3543).
Onze Lieve Vrouwe Gasthuis, Amsterdam, The Netherlands.
ISSUE/PROBLEM: The department of liaison psychiatry of the major general hospital in the city of Amsterdam is frequently consulted for the treatment of patients with HIV/AIDS. Due to the current attitude in the Netherlands toward euthanasia and physician assisted suicide, the psychiatrist is confronted with dilemmas regarding suicide, assistance in self-induced death and requests for euthanasia, in addition to the more traditional psychiatric treatment and counseling activities. DESCRIPTION OF PROJECT: While euthanasia remains legally a criminal act in the Netherlands, 54% of physicians surveyed have performed euthanasia or assisted suicides. This presentation concerns the dilemmas of the psychiatrist confronted with the concerns of HIV-infected patients about life, death and their way of dying. The psychiatrist's role is to assess the patient's state of mind and to assist the patient in formulating a balance of thoughts and feelings while the illness progresses. RESULTS: The legal regulations and the professional guidelines in the Netherlands provide a framework in which several dilemmas present themselves to the psychiatrist. Following the period of counseling in the initial phase of adaptation to the diagnosis of HIV-infection/AIDS, questions about life and death can become prominent in several different situation; in patients with intact consciousness and unimpaired judgement; in patients with a (developing) organic brain syndrome; in patients with a premorbid psychiatric history; in patients with a current psychiatric disorder. LESSONS LEARNED: When physician assisted death becomes a treatment option, the psychiatrist has a role in clarifying patients questions on death and ways of dying. In doing so the psychiatrist is confronted with moral, ethical and professional dilemmas in deciding whether a patient's request for assistance in dying is appropriate and to which point he/she is willing to go to meet the patient's expressed needs. The psychiatrist is sometimes the case-manager in guidance toward a balance among the choices of acceptance of treatment, refusal of treatment, suicide, assisted self-induced death and euthanasia.
Publication Types:
Keywords:
- Acquired Immunodeficiency Syndrome
- Counseling
- Death
- Depression
- Ego
- Euthanasia
- HIV Seropositivity
- Helping Behavior
- Humans
- Mental Disorders
- Netherlands
- Psychiatry
- Suicide, Assisted
Other ID:
UI: 102198988
From Meeting Abstracts