In November 1998, I read an article in Psychiatric Services that shocked me. Schoevers, Asmus, and Van Tilburg (1998, p. 1476) told the story of a 50-yearold physically healthy Dutch woman, who was grieving over the death of her sole surviving son. She died after taking lethal medication given to her by her doctor.
Before reading this article, I had been vaguely aware of the physician-assisted suicide movement and wary of how it might transform the practice of the mental health professions, but I had considered this an unlikely possibility. However this article jolted me into awareness.
At the time of Schoevers, Asmus, and Van Tilburg’s article, the Dutch had not yet made physician-assisted suicide or euthanasia legal—this finally occurred on April 10, 2001 (Dutch upper house, 2001)—but they had a set of guidelines. If the physician followed the guidelines, he was not prosecuted.
I was surprised to find that these guidelines had already been extended to include psychiatric patients. The Dutch Board of Psychiatrists had already claimed in 1992 that “suffering from a mental illness is not essentially different from suffering from medical diseases” and that “psychopathology in itself does not automatically make a person incapable of having an autonomous wish to die.” In 1997, a report was issued by the Royal Dutch Medical Association and the General Inspection of Mental Health extending the guidelines so that a Dutch psychiatric patient could request assistance with suicide (Schoevers, Asmus, & Van Tilburg, p. 1475). Schoevers, Asmus, and Van Tilburg, although they made