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. 2021 May 25;12:537379. doi: 10.3389/fpsyt.2021.537379

Table 1.

Survey items [based on (17)].

1: Questions on the treatment of patients with severe and persistent mental illness (SPMI)
In the treatment of patients with SPMI, how important is (a) curing the illness?
(b) reduction of suffering?
(c) the patient's ability to function in daily life?
(d) the patient remaining autonomous in their decision making?
(e) impeding suicide?
According to the World Health Organization, palliative care “is an approach that improves the quality of life of patients and their families facing the problem associated with life-threatening illness, through the prevention and relief of suffering by means of early identification and impeccable assessment and treatment of pain and other problems, physical, psychosocial and spiritual.”
How strongly do you agree or disagree with the following? (f) For me, the term “palliative” relates directly to end of life.
(g) For some SPMI patients, palliative care is indicated.
(h) In psychiatry, applying a palliative care model is important in providing optimal support for certain patients without a life-limiting medical illness.
(i) In severe, chronic and therapy-refractory anorexia nervosa, a palliative approach would be suitable.
(j) In severe, chronic and therapy-refractory schizophrenia, a palliative approach would be suitable.
(k) In severe, chronic and therapy-refractory depression, a palliative approach would be suitable.
(l) In severe, chronic and therapy-refractory bipolar disorder, a palliative approach would be suitable.
(m) In severe, chronic and therapy-refractory substance disorder, a palliative approach would be suitable.
How strongly do you agree or disagree with the following? (n) SPMI can be a terminal illness.
(o) Sedation for the reduction of unbearable refractory psychological symptoms is justifiable in certain cases of SPMI.
(p) I would generally be willing to perform sedation as mentioned in item o.
(q) I generally advocate for the access to assisted suicide for patients with SPMI.
(r) I would generally support a patient in his or her wish to seek assisted suicide by writing a medical report or referring him or her to a respective organization.
2: Questions about the three case vignettes
Please evaluate the three case vignettes. (a) I would not be surprised if this patient died within the next 6 months.
(b) For this patient, further curative interventions would most likely be futile.
(c) In this case, I would be comfortable with a reduction of life expectancy to increase or maintain quality of life if consistent with the patient's goals.
(d) In this case, I would accept a temporary decrease in quality of life because of coercive measures.
(e) In this case, I would not proceed against the patient's wishes.
(f) In this case, sedation to reduce an unbearable refractory symptom is reasonable.
(g) If there is an explicit and enduring wish for assisted suicide, I would support this patient in his or her plan and refer him or her to a respective organization.

The Table has been designed in the style of Hodel et al. (19) and Trachsel et al. (17). The items relevant for this article are tagged in bold.