Persons with mental disorders and assisted dying practices in Spain: An overview.

On 25 June 2021, the Law on Euthanasia in Spain came into force, providing for two modes of helping an individual end their life: euthanasia and/or medically assisted suicide. Among the requisites that a request for euthanasia has to fulfil are that the individual must be suffering a severe, chronic and debilitating condition or a severe and incurable disease, at the same time as that person shows the necessary competence to decide. The possibility exists that a patient suffering mental health problems submits such a request; however, the specific characteristics of a mental health disorder make such a request considerably more complex. In this article, based on a narrative review of the law itself and the related literature, the requisites established under the law are analysed from an ethical-legal perspective with the aim of defining when a request for euthanasia from a person with a mental health disorder may be deemed legitimate and in line with legal provisions. This should help clinicians make rational, reasoned decisions when dealing with a request of this type.

Pregnancy beyond 65: report of a unique case and discussion of a controversial issue.

We present the case report of a 66-year-old woman who was attended at our gynaecology department at a tertiary university hospital in Barcelona, Spain for a high-risk pregnancy and comment on the obstetric implications and bioethical issues. We retrospectively analysed clinical data about the case and bibliographic references related to the issue. The woman underwent in vitro fertilisation of donated embryos in a private centre and came to our unit at 27 weeks of gestation for pregnancy care. At 33 weeks, she presented pre-eclampsia and a caesarean section was performed. She gave birth to healthy twin boys. Four months later, she returned to our centre with the diagnosis of ovarian cancer and died 30 months after delivery. We present the clinical course and management of this pregnancy and comment on the obstetric implications, the impact on maternal and neonatal health, and bioethical issues related to assisted reproduction techniques in pregnancies beyond the natural reproductive age.