Objective:

To explore the complex interplay of clinical practice, bioethics, and legal evaluation in euthanasia and assisted suicide (EAS) for individuals with mental disorders, emphasizing ethical implications.

Key Findings:

• Five central domains for psychiatric EAS assessment include decision-making capacity, irremediability of suffering, subjective suffering and voluntariness, and safeguard systems, highlighting the need for multidisciplinary approaches.
• There is significant variability in legal models and clinical approaches across jurisdictions.
• Challenges include the lack of standardized criteria for irremediability and inter-rater variability in capacity assessment.

Interpretation:

Psychiatric EAS requires careful evaluation due to the complexity and variability of mental disorders, necessitating multidisciplinary approaches to enhance decision-making.

Limitations:

• Absence of standardized criteria for irremediability.
• Inter-rater variability in capacity assessment.
• Difficulty in distinguishing between psychopathology-related suicidality and well-considered requests for assisted death, compounded by cultural differences.

Conclusion:

Psychiatric EAS remains a challenging topic, with structured and multidisciplinary evaluation processes potentially enhancing consistency and ethical sustainability. Ongoing research is essential.