2 Understanding euthanasia beyond biology: exploring the psychosocial determinants with respect to euthanasia decisions from Indian mental health professionals

Euthanasia is a debatable topic due to its legal, ethical, and spiritual complications. Euthanasia is prescribed to hasten the death of a clinical patient with the intent of preventing further suffering and pain. The discourse around the acceptability of euthanasia is not yet substantiated, where some countries have legalized the practice while others have not. We believe, the studies conducted on euthanasia so far take a positivist approach attempting to describe the moral perceptions of euthanasia. However, the current study uses a qualitative, deductive and social constructivist approach to understand this phenomenon. The objectives of the following study are a). to understand the process of euthanasia decisions from the perspective of Indian mental health professionals and b). to understand psychosocial determinants of euthanasia as elicited by MHPs. 12 Semi-structured interviews were conducted with mental health professionals using purposive sampling. The data was analyzed using deductive thematic analysis (Braun and Clarke, 2006) and 3 global themes were identified. 'Precursors to decisions of euthanasia' identifies the perceived drivers for euthanasia, why MHPs do not prescribe for euthanasia and how they might prepare the patient for taking such a decision. The second theme of Situating MHPs role in the process of decision talks about the psychological factors that MHPs my be required to consider before taking a call. Finally, 'Decision of euthanasia lying beyond the patient' encompasses the social determinants of euthanasia. The presented study does not add to the debate surrounding the appropriateness of the process, euthanasia rather gives a turn around mental health from the professionals in the field incorporation new dimensions namely the psychosocial modality to euthanasia which can be implied to gain a holistic understating of the patient, their illness and in turn the decision for euthanasia.