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Assisted Death/Euthanasia & Mental Disorders 

Nicolini, M.E., Jardas, E., Zarate, C.A., Gastmans, C., Kim, S.Y.H. Irremediability in psychiatric euthanasia: Examining the objective standard. Psychological Medicine 2022, 1-19. pdf here 

Summary: Incurability or "irremediability" is a core requirement for assisted death/euthanasia. Guidelines task clinicians to assess incurability objectively. This paper finds that in psychiatry there are no such objective standards for clinicians to rely on. 

Nicolini, M.E., Gastmans, C., Kim, S.Y.H. Psychiatric euthanasia, suicide and the role of gender. British Journal of Psychiatry. 2021; 220(1), 10-13. pdf here 

Summary: This is the first paper to look at the striking finding that women are overrepresented among psychiatric euthanasia cases (about 75% are women) and what this tells us about the practice and its relation with suicide prevention. 

* Selected as the Article of the Month for Jan 2022 by the Royal College of Psychiatrists

Nicolini, M.E., Gastmans, C., Kim, S.Y.H. Parity arguments for ‘physician aid-in-dying' for psychiatric disorders: Their structure and limits. American Journal of  Bioethics 2019; 19(10): 3-7. pdf here

Summary: The parity argument states that if we allow euthanasia/MAiD for physical suffering, we should allow it for mental suffering. This paper argues that the argument should focus not on suffering, but on the relevant differences between mental and physical disorders.

Nicolini, M. E., Kim, S.Y.H., Churchill, M. E., Gastmans, C. Should euthanasia and assisted suicide for psychiatric disorders be permitted? A systematic review of reasons. Psychological Medicine 2020; 50(8): 1241-1256.  pdf here

Summary: The debate over psychiatric euthanasia started 25 years ago, yet a comprehensive overview of the professional debate was lacking. This systematic review fills this gap, identifies the main arguments for and against the practice, and outlines avenues for future research. 

Nicolini, M.E., Peteet, J.R., Donovan, G.K., Kim, S.Y.H. Euthanasia and assisted suicide of persons with psychiatric disorders: The challenge of personality disorders. Psychological Medicine. 201950(4): 575-582. pdf here

Summary: Over 50% of psychiatric euthanasia cases in Belgium and the Netherlands involve people with personality disorders or difficulties. Frequent symptoms like chronic hopelessness and suicidality may overlap with eligibility requirements for euthanasia. This study is the first to focus on patients with personality disorders and how their requests are evaluated.

Assisted Death/Euthanasia & Dementia 


Nicolini, M.E. Physician aid in dying for dementia. The problem with the early versus late disease stage distinction. Frontiers in Psychiatry. 2021; 12(1653).  pdf here

Kim, S.Y.H., Mangino, D., Nicolini, M.EIs this person with dementia (currently) competent to request euthanasia? A complicated and under-explored question. Journal of Medical Ethics. 2021; 47:e41. pdf here

Kim, S. Y.H., Nicolini, M.E., Mangino, D. R., De Vries, R.G. What we can learn from published reports of euthanasia in persons with dementia: A reply to Marijnisssen et al. American Journal of Geriatric Psychiatry. 2020.  pdf here

Mangino, D.R., Nicolini, M.E., De Vries, R.G., Kim, S.Y.H. Euthanasia and assisted suicide of persons with dementia in the Netherlands. American Journal of Geriatric Psychiatry. 201928(4): 466-477.  pdf here


Other Publications

De Vocht, J., Stam, D., Nicolini, M.E., Lamaire, N., Laroy, M., Vande Casteele, T., & ... Van den Stock, J. Psychopathology in premanifest C9orf72 repeat expansion carriers.

Journal of Neurology Neurosurgery & Psychiatry. 2021; jnnp-2021-327774. pdf here

Nicolini, M.E. From Mental Health Act admission to medical assistance in dying. Unraveling the conceptual questions. International Network for the History of Neuropsychopharmacology Controversies. 2022.  pdf here


Nicolini, M.E., Wendler, D. Inherent conflict of interest in clinical research: A call for effective guidance. American Journal of Bioethics. 2020; 20(10):94-96. pdf

Grady, C., Shah, S., Miller, F., Danis, M., Nicolini, M.E., Ochoa, J., Taylor, H., Wendler, D., Rid, A. So much at stake: ethical trade-offs in accelerating SARS-Cov-2 vaccine development. Vaccine 2020; 38(41): 6381-6387. pdf here

Rid, A., Shah, S., Miller, F., Danis M., Nicolini, M.E., Ochoa, J., Taylor, H., Wendler, D., Grady, C. Ethical trade-offs in vaccine development and distribution: Response to Gurwitz. Vaccine. 2021; 39(2): 1028-1029  

Nicolini, M.E., Vandenberghe, J., Gastmans, C. Substance use disorder and compulsory commitment to care: A care-ethical decision-making framework. Scand J Caring Sci. 2018; 32(3):1237-1246. pdf here

In Dutch  

Nicolini, M.E., Kim, S. Y.H. Euthanasie bij persoonlijkheidsstoornissen. [Dutch summary of paper published in Psychol Med] Neuron. 2019. pdf here

Nicolini, M.E. Ethische handvaten voor procedure gedwongen opname bij verslaving. Kiezen voor dialoog. [Ethical tools for compulsory commitment in persons with substance use disorders. Choosing dialogue] Zorgwijzer (Zorgnet Icuro). 2018 pdf here

Nicolini, M.EWie wij zijn. [Who we are] F. Koerselman (2016). Prometeus Amsterdam. ISBN 978-90-351-3699-1, 255pp. Tijdschrift voor Psychoanalyse 2018; 24(3).  pdf here

PhD Thesis

Nicolini, M.E. Euthanasia and assisted suicide for psychiatric disorders. Clinical and ethical perspectives. PhD Thesis. May 2021. KU Leuven. pdf here

Work in Progress

"Suicide prevention and assisted suicide for chronic conditions: The impasse of moral incoherence"

"Respect: Psychiatry’s silent crisis" (with Diane O’Leary)

"The gap in the psychiatric euthanasia debate", chapter iEthics in Psychiatry, 2nd ed., Springer

Chapter in Medical Professionalism. Oxford University Press (with Christine Grady) [Forthcoming]

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