Objective:

To systematically review cases of assisted death among patients with eating disorders and identify reporting gaps.

Approach:

• Systematic Search: Conducted a systematic search of peer-reviewed literature and government reports from jurisdictions where assisted dying was legal for psychiatric conditions.
• Content Analysis: Performed content analysis to identify clinical rationales for assisted death, categorized into terminality, irremediability, and voluntary request.

Key Findings:

• Identified at least 60 cases of assisted death among patients with eating disorders from 2012 to 2024.
• All identified cases involved female patients, with 61% having more than three comorbid psychiatric disorders.
• 68% were severely underweight or malnourished at the time of their requests.
• 89% exhibited depressive symptoms and 63% exhibited anxiety symptoms.
• 95% of cases cited illness duration as a rationale for assisted death, with 89% emphasizing poor prognosis and treatment failure.

Interpretation:

The review highlights significant gaps in reporting and raises ethical concerns regarding decision-making capacity in patients with eating disorders.

Limitations:

• Only 16 out of 27 jurisdictions with legal assisted dying regularly published reports.
• Lack of detailed psychiatric diagnosis information in reports.

Conclusion:

The study calls for improved reporting in public health records and the development of a framework to guide care for patients with eating disorders expressing a wish to die.

Sources:

• Frontiers in Psychiatry