ABSTRACT The Dutch case of Brongersma presents novel challenges to the definition and evaluation of voluntary euthanasia since it involved a doctor assisting the suicide of an individual who was (merely?) ‘tired of life’. Legal officials had called on the courts to ‘set a principled boundary’, excluding such cases from the scope of permissible voluntary euthanasia, but they arguably failed. This failure is explicable, however, since the case seems justifiable by reference to the two major principles in favour of that (...) practice, respect for autonomy and beneficence. Ultimately, it will be argued that those proponents of voluntary euthanasia who are wary of its use in such circumstances may need to draw upon ‘practical’ objections, in order to erect an otherwise arbitrary perimeter. Furthermore, it will be suggested that the issues raised by the case are not peculiarly Dutch in nature and that, therefore, there are lessons here for other jurisdictions too. (shrink)

Too little attention has been paid by philosophers to the cognitive and epistemic dimensions of emotional disturbances such as depression, grief, and anxiety and to the possibility of justification or warrant for such conditions. The chief aim of the present paper is to help to remedy that deficiency with respect to depression. Taxonomy of depression reveals two distinct forms: depression (1) with intentionality and (2) without intentionality. Depression with intentionality can be justified or unjustified, warranted or unwarranted. I argue that (...) the effort of Aaron Beck to show that depressive reasoning is necessarily illogical and distorted is flawed. I identify an essential characteristic of that depression which is a mental illness. Finally, I describe the potential of depression to provide credal contact with important truths. (shrink)

One of the requirements in the Dutch regulation for euthanasia and assisted suicide is that the doctor must be satisfied ‘that the patient's suffering is unbearable, and that there is no prospect of improvement.’ In the notorious Chabot case, a psychiatrist assisted a 50 year old woman in suicide, although she did not suffer from any somatic disease, nor strictly speaking from any psychiatric condition. In Seduced by Death, Herbert Hendin concluded that apparently the Dutch regulation now allows physicians to (...) assist anyone in suicide simply because he or she is unhappy.In this paper, I reject Hendin's conclusion and in particular his description of Mrs Boomsma as someone who was ‘simply unhappy.’ After a detailed narration of her lifestory, I turn to the American philosopher Harry Frankfurt's account of volitional incapacity and love for a more accurate characterization of her suffering. Having been through what she had, she could only go on living as another person than the one she had been when she was a happy mother. That would have violated her integrity, and that she could not bring herself to do. (shrink)

Some psychiatrists believe that “demoralization syndrome” is a diagnosable cognitive disorder characterized in its extreme form by morbid existential distress. If they are right, then it should be an important part of our thinking about end of life decisionmaking. A demoralized patient would be unable to think reliably about the remainder of her life, and therefore incompetent to decide to commit physician‐assisted suicide.