What happens after a request for euthanasia is refused? Qualitative interviews with patients, relatives and...

Area of Science:

• Medical Ethics
• Palliative Care
• Patient-Physician Communication

Background:

• Requests for euthanasia or physician-assisted suicide (EAS) are sometimes refused.
• Understanding the patient and physician experiences post-refusal is crucial for patient care.

Purpose of the Study:

• To explore patient and physician perspectives on the aftermath of refused EAS requests.
• To identify communication patterns and unmet needs following EAS refusal.

Main Methods:

• Conducted in-depth interviews with patients refused EAS, their physicians, and relatives of deceased patients.
• Interviews occurred at least six months after the EAS request refusal.

Main Results:

• Patients often maintained a desire to die after refusal, though intensity varied.
• Discussions about the wish to die frequently ceased post-refusal.
• Physicians acknowledged patients' continued wish to die but rarely planned future care or evaluated the situation post-refusal.

Conclusions:

• Patients refused EAS may not voice their continued wish to die, impacting their quality of life.
• Open communication regarding end-of-life wishes, beyond EAS, is essential.
• Follow-up appointments are recommended to facilitate discussion and physician support.