scholarly journals “Nothing Hurts Less Than Being Dead”: Psychological Pain in Case Descriptions of Psychiatric Euthanasia and Assisted Suicide from the Netherlands: « Rien ne fait moins mal qu’être mort »: La douleur psychologique dans les descriptions de cas d’euthanasie et de suicide assisté psychiatrique aux Pays-Bas

2020 ◽  
Vol 65 (9) ◽  
pp. 612-620
Author(s):  
Aiste Lengvenyte ◽  
Robertas Strumila ◽  
Philippe Courtet ◽  
Scott Y. H. Kim ◽  
Emilie Olié

Objectives: Euthanasia and assisted suicide (EAS) of individuals with mental disorders is a growing practice in several countries, including the Netherlands. Here, we aimed to identify the most frequent dimensions of and associated factors to psychological pain, which has been associated with suicidality, in individuals undergoing psychiatric EAS. Methods: An exploratory retrospective content analysis of the English translation of 66 digital case records of individuals who died by EAS in the Netherlands between 2011 and 2014 was performed. Nine standard psychological pain dimensions (irreversibility, loss of control, emptiness, emotional flooding, freezing, social distancing, narcissistic wounds, confusion, and self-estrangement), illness, and sociodemographic variables were evaluated by 2 independent raters using a premade data abstraction form (Kohen κ > 0.8 in all cases). Results: The mean number of dimensions was 4.64 ± 1.20 (median = 5), out of 9. The most frequent dimensions were irreversibility, loss of control, emptiness, and emotional flooding, in decreasing order. Past treatment refusal and the mention of social connections in case descriptions were related to the higher number of psychological pain dimensions (4.89 ± 1.24 vs. 4.31 ± 1.07, P = 0.03 and 5.05 ± 1.17 vs. 4.43 ± 1.17, P = 0.03, respectively). Emotional flooding was the only dimension specifically associated with specific psychiatric conditions, namely posttraumatic phenomena and personality disorders. Conclusions: Numerous psychological pain dimensions were detected in case descriptions of individuals who underwent EAS before the procedure. Subjective nature of the study precludes definite conclusions but suggest that future studies should explore psychological pain and the role of interventions targeting it in patients requesting EAS.

2016 ◽  
Vol 14 (3) ◽  
pp. 243-253
Author(s):  
Grzegorz Stefanowicz

This article undertakes to show the way that has led to the statutory decriminalization of euthanasia-related murder and assisted suicide in the Kingdom of the Netherlands. It presents the evolution of the views held by Dutch society on the euthanasia related practice, in the consequence of which death on demand has become legal after less than thirty years. Due attention is paid to the role of organs of public authority in these changes, with a particular emphasis put on the role of the Dutch Parliament – the States General. Because of scarcity of space and limited length of the article, the change in the attitudes toward euthanasia, which has taken place in the Netherlands, is presented in a synthetic way – from the first discussions on admissibility of a euthanasia-related murder carried out in the 1970s, through the practice of killing patients at their request, which was against the law at that time, but with years began more and more acceptable, up to the statutory decriminalization of euthanasia by the Dutch Parliament, made with the support of the majority of society.


2021 ◽  
pp. 1-4
Author(s):  
Marie E. Nicolini ◽  
Chris Gastmans ◽  
Scott Y.H. Kim

The preponderance of women among persons who request and receive euthanasia and assisted suicide based on a psychiatric condition, as shown by data from The Netherlands and Belgium, is virtually unexplored. We provide a critical discussion of this gender gap, and propose that it can inform a key debate point in the controversy over the practice, namely its conflict with suicide prevention.


2008 ◽  
Vol 34 (4) ◽  
pp. 254-258 ◽  
Author(s):  
G G van Bruchem-van de Scheur ◽  
A J G v. d. Arend ◽  
H H. Abu-Saad ◽  
C Spreeuwenberg ◽  
F C B van Wijmen ◽  
...  

2008 ◽  
Vol 15 (2) ◽  
pp. 186-198 ◽  
Author(s):  
Ada van Bruchem-van de Scheur ◽  
Arie van der Arend ◽  
Frans van Wijmen ◽  
Huda Huijer Abu-Saad ◽  
Ruud ter Meulen

This article presents the attitudes of nurses towards three issues concerning their role in euthanasia and physician-assisted suicide. A questionnaire survey was conducted with 1509 nurses who were employed in hospitals, home care organizations and nursing homes. The study was conducted in the Netherlands between January 2001 and August 2004. The results show that less than half (45%) of nurses would be willing to serve on committees reviewing cases of euthanasia and physician-assisted suicide. More than half of the nurses (58.2%) found it too far-reaching to oblige physicians to consult a nurse in the decision-making process. The majority of the nurses stated that preparing euthanatics (62.9%) and inserting an infusion needle to administer the euthanatics (54.1%) should not be accepted as nursing tasks. The findings are discussed in the context of common practices and policies in the Netherlands, and a recommendation is made not to include these three issues in new regulations on the role of nurses in euthanasia and physician-assisted suicide.


Author(s):  
Linda MEIJER-WASSENAAR ◽  
Diny VAN EST

How can a supreme audit institution (SAI) use design thinking in auditing? SAIs audit the way taxpayers’ money is collected and spent. Adding design thinking to their activities is not to be taken lightly. SAIs independently check whether public organizations have done the right things in the right way, but the organizations might not be willing to act upon a SAI’s recommendations. Can you imagine the role of design in audits? In this paper we share our experiences of some design approaches in the work of one SAI: the Netherlands Court of Audit (NCA). Design thinking needs to be adapted (Dorst, 2015a) before it can be used by SAIs such as the NCA in order to reflect their independent, autonomous status. To dive deeper into design thinking, Buchanan’s design framework (2015) and different ways of reasoning (Dorst, 2015b) are used to explore how design thinking can be adapted for audits.


2012 ◽  
pp. 66-77 ◽  
Author(s):  
I. A. Lavrinenko ◽  
O. V. Lavrinenko ◽  
D. V. Dobrynin

The satellite images show that the area of marshes in the Kolokolkova bay was notstable during the period from 1973 up to 2011. Until 2010 it varied from 357 to 636 ha. After a severe storm happened on July 24–25, 2010 the total area of marshes was reduced up to 43–50 ha. The mean value of NDVI for studied marshes, reflecting the green biomass, varied from 0.13 to 0.32 before the storm in 2010, after the storm the NDVI decreased to 0.10, in 2011 — 0.03. A comparative analysis of species composition and structure of plant communities described in 2002 and 2011, allowed to evaluate the vegetation changes of marshes of the different topographic levels. They are fol­lowing: a total destruction of plant communities of the ass. Puccinellietum phryganodis and ass. Caricetum subspathaceae on low and middle marches; increasing role of halophytic species in plant communities of the ass. Caricetum glareosae vic. Calamagrostis deschampsioides subass. typicum on middle marches; some changes in species composition and structure of plant communities of the ass. Caricetum glareosae vic. Calamagrostis deschampsioides subass. festucetosum rubrae on high marches and ass. Parnassio palustris–Salicetum reptantis in transition zone between marches and tundra without changes of their syntaxonomy; a death of moss cover in plant communities of the ass. Caricetum mackenziei var. Warnstorfia exannulata on brackish coastal bogs. The possible reasons of dramatic vegetation dynamics are discussed. The dating of the storm makes it possible to observe the directions and rates of the succession of marches vegetation.


2020 ◽  
Author(s):  
Charles Scelles ◽  
LUIS CARLO BULNES

Eye Movement Desensitization and Reprocessing (EMDR) is a treatment for post-traumatic stressdisorder (PTSD). The technique is known to stimulate the capacity to reprocess maladaptive memoriesthat are thought to be central to this pathology. Here we investigate if EMDR therapy can be used in otherconditions than PTSD. We conducted a systematic literature search on PubMed, ScienceDirect, Scopus, and Web of Science. Wesearched for published empirical findings on EMDR, excluding those centred on trauma and PTSD,published up to 2020. The results were classified by psychiatric categories.   Ninety articles met our research criteria. A positive effect was reported in addictions, somatoformdisorders, sexual dysfunction, eating disorder, disorders of adult personality, mood disorders, reaction tosevere stress, anxiety disorders, performance anxiety, Obsessive-Compulsive Disorder (OCD), pain,neurodegenerative disorders, paedopsychiatry and sleep. The evidence was more consistent in pain, OCD,mood disorders, and reaction to severe stress.EMDR’s efficiency across numerous pathological situations, highlighted the central role of affectivememory in several psychiatric and non-psychiatric conditions. Furthermore, EMDR seems to besuccessful in usually uncooperative (e.g. Dementia) or unproductive cases (e.g. aphasia). Moreover, insome severe medical situations were psychologic distress was an obstacle, EMDR allowed thecontinuation of treatment-as-usual. Our review suggests that it is a safe and economical therapeuticoption, and its effect in non-pathological situations opens new avenues for translational research. Overallmore methodologically rigorous studies are needed.


2004 ◽  
Vol 35 (2) ◽  
pp. 119-137 ◽  
Author(s):  
S.D. Gurney ◽  
D.S.L. Lawrence

Seasonal variations in the stable isotopic composition of snow and meltwater were investigated in a sub-arctic, mountainous, but non-glacial, catchment at Okstindan in northern Norway based on analyses of δ18O and δD. Samples were collected during four field periods (August 1998; April 1999; June 1999 and August 1999) at three sites lying on an altitudinal transect (740–970 m a.s.l.). Snowpack data display an increase in the mean values of δ18O (increasing from a mean value of −13.51 to −11.49‰ between April and August), as well as a decrease in variability through the melt period. Comparison with a regional meteoric water line indicates that the slope of the δ18O–δD line for the snowpacks decreases over the same period, dropping from 7.49 to approximately 6.2.This change points to the role of evaporation in snowpack ablation and is confirmed by the vertical profile of deuterium excess. Snowpack seepage data, although limited, also suggest reduced values of δD, as might be associated with local evaporation during meltwater generation. In general, meltwaters were depleted in δ18O relative to the source snowpack at the peak of the melt (June), but later in the year (August) the difference between the two was not statistically significant. The diurnal pattern of isotopic composition indicates that the most depleted meltwaters coincide with the peak in temperature and, hence, meltwater production.


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