Exploring the interplay of clinical, ethical and societal dynamics: two decades of Medical Assistance in Dying (MAID) on psychiatric grounds in the Netherlands and Belgium

. 2024 Sep 11;15:1463813. doi: 10.3389/fpsyt.2024.1463813

Initiatives in Flanders, Belgium
REAKIRO Reakiro is a place in Louvain (2020) and West-Flanders (2022) where individuals considering MAID on psychiatric grounds, and their relatives, can go to. The primary focus of Reakiro is rooted in the rehabilitation approach, characterised by an active orientation towards life, towards (re)discovering meaning, purpose and hope in life, without excluding the option of euthanasia. This rehabilitation approach is founded on the following 4 main pillars to qualitative (end-of-life) care: the medical, psychological, social and existential care approach. Within Reakiro, individual support is provided alongside group support in the form of peer-to-peer interactions. https://reakiro.be/ (in Dutch) OYSTER CARE In Belgium, the 'Oyster Care' model offers an innovative approach in psychiatry for individuals with Severe and Persistent Mental Illnesses (SPMI), addressing challenges faced by those considering euthanasia when traditional treatments have proven ineffective. by palliative care principles, it prioritizes quality of life through a holistic approach, acknowledging the interconnectedness of various facets of an individual's well-being. 'Oyster Care' endeavors to establish a supportive 'shell' around SPMI individuals, metaphorically representing the external environmental support necessary for the cultivation of a fulfilling life. It acknowledges the reality that complete recovery or reintegration may not always be feasible, and thus, strives to optimize the quality of life attainable within the given circumstances. https://www.crustatievezorg.be/ (in Dutch)

Initiatives in Flanders, Belgium

REAKIRO
Reakiro is a place in Louvain (2020) and West-Flanders (2022) where individuals considering MAID on psychiatric grounds, and their relatives, can go to. The primary focus of Reakiro is rooted in the rehabilitation approach, characterised by an active orientation towards life, towards (re)discovering meaning, purpose and hope in life, without excluding the option of euthanasia. This rehabilitation approach is founded on the following 4 main pillars to qualitative (end-of-life) care: the medical, psychological, social and existential care approach. Within Reakiro, individual support is provided alongside group support in the form of peer-to-peer interactions.
https://reakiro.be/ (in Dutch)
OYSTER CARE
In Belgium, the 'Oyster Care' model offers an innovative approach in psychiatry for individuals with Severe and Persistent Mental Illnesses (SPMI), addressing challenges faced by those considering euthanasia when traditional treatments have proven ineffective. by palliative care principles, it prioritizes quality of life through a holistic approach, acknowledging the interconnectedness of various facets of an individual's well-being. 'Oyster Care' endeavors to establish a supportive 'shell' around SPMI individuals, metaphorically representing the external environmental support necessary for the cultivation of a fulfilling life. It acknowledges the reality that complete recovery or reintegration may not always be feasible, and thus, strives to optimize the quality of life attainable within the given circumstances.
https://www.crustatievezorg.be/ (in Dutch)

Initiatives in the Netherlands
THANET ThaNet was established in 2023 and funded by the Ministry of Health, with the primary objective of augmenting the accessibility and quality of care provided to individuals presenting with a persistent wish to die or a MAID request on psychiatric grounds. Its overarching mission is to systematically facilitate and promote these objectives throughout the entirety of the mental health care system. ThaNet endeavors to enhance the standard of care for individuals expressing a MAID request or enduring a persistent desire for death by instituting a collaborative learning network comprising healthcare professionals operating within mental health care institutions, hospitals, and academic centers. ThaNet facilitates a network where mental healthcare professionals can come together, get acquainted with the subject matter, receive practical guidance and learn how to deal with persistent wishes to die and MAID requests on psychiatric grounds. https://thanet.nl/ (in Dutch)

Initiatives in the Netherlands

THANET
ThaNet was established in 2023 and funded by the Ministry of Health, with the primary objective of augmenting the accessibility and quality of care provided to individuals presenting with a persistent wish to die or a MAID request on psychiatric grounds. Its overarching mission is to systematically facilitate and promote these objectives throughout the entirety of the mental health care system. ThaNet endeavors to enhance the standard of care for individuals expressing a MAID request or enduring a persistent desire for death by instituting a collaborative learning network comprising healthcare professionals operating within mental health care institutions, hospitals, and academic centers. ThaNet facilitates a network where mental healthcare professionals can come together, get acquainted with the subject matter, receive practical guidance and learn how to deal with persistent wishes to die and MAID requests on psychiatric grounds.
https://thanet.nl/ (in Dutch)