Psychiatric Euthanasia, Mental Capacity, and a Sense of the Possible

TY - JOUR

T1 - Psychiatric Euthanasia, Mental Capacity, and a Sense of the Possible

AU - Ratcliffe, Matthew James

PY - 2020/9/26

Y1 - 2020/9/26

N2 - Euthanasia for psychiatric conditions is currently legal in Belgium and the Netherlands. It is also highly controversial, as illustrated by some recent, high-profile cases. In this paper, I show how a better understanding of the associated phenomenology can inform debate in this area. I focus on how phenomenological changes that occur in psychiatric illness can erode the ability to experience and entertain certain types of possibility, making some scenarios seem inevitable and others impossible. Although strong convictions that originate in competent decisions differ from verbal and non-verbal behaviours stemming from losses of possibility, detecting the difference is by no means straightforward. I add that a sense of the possible can be sustained, enhanced, or diminished by ways of experiencing and relating to other people. Consequently, the extent to which decision-making capacity is impaired in a given case may vary with interpersonal context. I consider the implications of these points for evaluating euthanasia as a response to mental suffering.

AB - Euthanasia for psychiatric conditions is currently legal in Belgium and the Netherlands. It is also highly controversial, as illustrated by some recent, high-profile cases. In this paper, I show how a better understanding of the associated phenomenology can inform debate in this area. I focus on how phenomenological changes that occur in psychiatric illness can erode the ability to experience and entertain certain types of possibility, making some scenarios seem inevitable and others impossible. Although strong convictions that originate in competent decisions differ from verbal and non-verbal behaviours stemming from losses of possibility, detecting the difference is by no means straightforward. I add that a sense of the possible can be sustained, enhanced, or diminished by ways of experiencing and relating to other people. Consequently, the extent to which decision-making capacity is impaired in a given case may vary with interpersonal context. I consider the implications of these points for evaluating euthanasia as a response to mental suffering.

KW - assisted dying

KW - decision-making

KW - depression

KW - mental capacity

KW - phenomenology

U2 - 10.1353/ppp.2020.0041

DO - 10.1353/ppp.2020.0041

M3 - Article

SN - 1071-6076

VL - 27

SP - E-1-E-15

JO - Philosophy, Psychiatry and Psychology

JF - Philosophy, Psychiatry and Psychology

IS - 3

ER -