Table 2:

Participant quotes about the definition of irremediable psychiatric suffering

1“When someone says, ‘I have a chronic disorder that will not go away,’ when all the experts agree and when it causes suffering, then the suffering is irremediable.” (P6)
2“We all know examples of people with, for example, therapy-resistant depression, which we have more or less given up … and then a few years later you find out to your surprise that they have found their way and have recovered. That makes [establishing irremediable psychiatric suffering] very difficult.” (P11)
3“If someone has gone through all the [treatments] and there is nothing left of which you can say, ‘If you do that, it will be different.’ … Then I think [the suffering] is irremediable.” (P5)
4“I think [in psychiatry] it is very complicated [to establish irremediability]; with cancer you just know. Chemotherapy does nothing, there are no other options and then the tumour starts to grow and then … it just stops.” (P2)
5“(Hyperbolically) I think that if the same patient is seen by 10 different psychiatrists, you will get 10 completely different letters [describing the patient and advising on irremediability].” (P7)
6“We just have to accept that there will always be some degree of uncertainty. The moment I, as an independent psychiatrist, say, ‘I think the legal criteria have been met,’ then there is an uncertainty. There is a confidence interval around it. … Because it concerns a dichotomous choice of life or death, we want absolute 100% certainty … But this is not possible.” (P8)