Bibliographic record
Abstract
Back to table of contents Previous article Next article Annual MeetingFull AccessAnnual Meeting Panel to Examine the Evolution of Physician Aid in DyingMark MoranMark MoranSearch for more papers by this authorPublished Online:26 Feb 2023https://doi.org/10.1176/appi.pn.2023.03.3.26AbstractPanel members will discuss the challenge of defining standards for “irremediability” in psychiatric disorders and will discuss the impact of expanding laws regarding physician-assisted dying on marginalized populations suffering from life distress.Physician Aid in Dying (PAD), also known as Medical Aid in Dying (MAiD) has been legalized or decriminalized in over a dozen jurisdictions around the world, and assisted dying policies continue to evolve, including in the United States. Many jurisdictions are exploring whether to introduce PAD laws or expand existing law to include PAD based on a mental disorder.“The psychiatrist helping patients to consider this unique and permanent request has a responsibility to assess for potentially treatable contributing conditions, including demoralization,” says John Peteet, M.D.This year’s Annual Meeting in San Francisco will feature a panel discussion titled “Physician-Assisted Death and Psychiatric Disorders.” PAD for mental disorders has been permitted for two decades in the Netherlands and Belgium, and 2023 marks the legalization of the practice in Canada (to be introduced as of March 2023).John Peteet, M.D., will explore how capacity for PAD may differ from capacity to refuse treatment. He is an associate professor of psychiatry at Harvard Medical School and director of the psychosocial oncology and palliative care fellowship at the Dana-Farber Cancer Institute.“I plan to focus on the role of the psychiatrist in evaluating patients for capacity to request MAiD, which is a role we play in several U.S. jurisdictions now,” he told Psychiatric News. “I’ll be suggesting that rather than a straightforward assessment of depression and the intellectual understanding of what is involved, the psychiatrist as a physician helping patients to consider this unique and permanent request has a responsibility to assess for potentially treatable contributing conditions, including demoralization.”Case examples will illustrate that at stake is not only the patient’s cognitive capacity and DSM diagnosis, but also the patient’s emotional capacity and the professional and clinical responsibility of the doctor to the patient.K. Sonu Gaind, M.D., a professor of psychiatry at the University of Toronto and past president of the Canadian Psychiatric Association, will review the Canadian experience, as Canada moves toward providing MAiD for patients with psychiatric disorders. Gaind is on the Council of Canadian Academies Expert Panel reviewing PAD for mental disorders.Marie Nicolini, M.D., Ph.D., psychiatrist and researcher at the Belgian Research Foundation Flanders and Georgetown University, will discuss the history of PAD for patients with psychiatric disorders in the Netherlands and Belgium.Panel members will discuss the challenge of defining adequate standards for “irremediability” in psychiatric disorders and patient requests for PAD and discuss the potential impact of expanding PAD laws on marginalized populations suffering from life distress. ■ ISSUES NewArchived
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.007 | 0.015 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.003 | 0.001 |
| Scholarly communication | 0.004 | 0.004 |
| Open science | 0.002 | 0.004 |
| Research integrity | 0.010 | 0.008 |
| Insufficient payload (model declined to judge) | 0.152 | 0.066 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".