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SYSTEMATIC REVIEW article

Front. Psychiatry
Sec. Public Mental Health
Volume 15 - 2024 | doi: 10.3389/fpsyt.2024.1431771

Assisted Death in Eating Disorders: A Systematic Review of Cases and Clinical Rationales

Provisionally accepted
  • 1 Eat Breathe Thrive, Boulder, United States
  • 2 University at Buffalo, Buffalo, New York, United States

The final, formatted version of the article will be published soon.

    Background: Assisted dying for reasons solely related to an eating disorder (ED) has occurred in multiple countries, including those which restrict the practice to individuals with a terminal condition. The aims of this systematic review were to (1) identify all known cases of assisted deaths among patients with EDs and (2) describe the clinical rationales used to grant patients' requests for assisted death.We conducted a systematic search of peer-reviewed studies and publicly available government reports to identify cases of assisted death in patients with EDs. In reports that included qualitative data about the case, clinical rationales were extracted and grouped into domains by qualitative content analysis.We identified 10 peer-reviewed articles and 20 government reports describing at least 60 patients with EDs who underwent assisted dying between 2012 and 2024. Clinical rationales were categorized into three domains: irremediability, terminality, and voluntary request. Reports emphasized that patients with EDs who underwent assisted death had terminal, incurable, and/or untreatable conditions and had adequate decision-making capacity to make a life-ending decision. Most government reports did not include descriptive-enough data to verify psychiatric conditions.The results of our systematic review underscore considerable gaps in the reporting of assisted death in patients with psychiatric conditions, posing substantial concerns about oversight and public safety. In many cases, the clinical rationales that were used to affirm patients with EDs were eligible for assisted death lack validity and do not cohere with empirical understanding.

    Keywords: assisted dying, Eating Disorders, Anorexia Nervosa, Medical assistance in dying, Euthanasia, Assisted suicide, Severe and enduring eating disorders, severe and enduring anorexia

    Received: 12 May 2024; Accepted: 12 Jul 2024.

    Copyright: © 2024 Roff and Cook-Cottone. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Chelsea Roff, Eat Breathe Thrive, Boulder, United States

    Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.