Voluntary assisted dying for people with mental disorder

Background: Four European countries make voluntary assisted dying (VAD) available to people experiencing distress/suffering from either physical diseases or mental disorders. Outside Europe, VAD is only available to those with physical diseases.

Objective: To argue VAD should also be available to people suffering primary mental disorder and to suggest some eligibility criteria.

Conclusion: Australian and New Zealand VAD eligibility criteria should be modified to allow mental disorder. The distinction between physical and mental disorder is spurious. The current requirement that the disorder must be terminal should be extinguished. That some people with mental disorders lack capacity does not justify a blanket embargo excluding all such people from receiving VAD. People with mental disorder complete suicide at a greater rate than those who do not have mental disorder, proving that mental disorder may make life, for some people, not worth living. We propose some eligibility criteria. VAD applicants with mental disorders must have reached majority and possess decisional capacity. The person must find the suffering from the mental disorder makes life not worth living. The request and completion of VAD must not be impulsive but well considered. The mental disorder must have been present for a protracted period (longer than expected) and treatments have failed to satisfactorily reduce the suffering.