Women over represented among mental health patients requesting euthanasia

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Women and people with a lower level of education are overrepresented among people with mental health problems who requested euthanasia, according to a file analysis by the Euthanasia Expertise Center requested by the Ministry of Public Health. 60 percent of euthanasia requests based on psychiatric problems came from women. And 40 percent of patients in the study had a lower education level, compared to 29 percent in the Dutch population as a whole, Trouw reports.

The expertise center, previously called the End of Live Clinic, analyzed a sample of 1,700 files of psychiatric patients from the period 2012 to 2018 on age and gender, and examined the entire file of 1,308 patients. During this period, over 3,500 psychiatric patients applied for euthanasia, around 30 percent of the total requests. 

Of the patients in the study, 9.5 percent died by euthanasia. In the other cases, the request was denied or the patient changed their mind. A total of 59 patients took their own lives, most during the process or while on the waiting list, 8 after their request was rejected. 

The fact that women are overrepresented here is interesting, given the fact that men are strongly overrepresented in suicide figures. According to Steven Pleiter of the Euthanasia Expertise Center, this may be because suicide is rougher and more shocking than euthanasia. "Women may be more concerned with those around them; they want to say goodbye in a decent way," he said to Trouw. 

Men who turn to the Euthanasia Expertise Center more often suffer from addiction problems, and women more often suffered from mood disorders. The average age of women in this study is 50 years, of the men 49. A depressive mood disorder was the most common disorder across the board. Bullying, sexual abuse, or trauma played a role with relatively many patients.

According to the researchers, the higher representation of people with a lower education in this study may have to do with more educated people having better mechanisms to cope with the consequences of their illness and being better able to request and receive help. Pleiter does not think the high proportion of poorly educated people in this study is immediate cause for concern. "I think it's important that we as an organization give a serious response to their request. There is a feeling in the Netherlands that euthanasia is more for the upper crust. This shows that this is not always the case."

The researchers found that discussing the request for euthanasia often prompted patients to rather keep living. This happened in half of the cases. According to Pleiter, this shows how important it is to start a conversation about death. Mental healthcare can do more on this front, he said to Trouw. "Now the handling of requests rests on the shoulders of seven psychiatrists. We want to achieve better cooperation and distribution of workload with mental healthcare institutions."

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