Frames and counter-frames giving meaning to palliative care and euthanasia in the Netherlands

Area of Science:

• Medical Ethics
• Sociology of Health
• Communication Studies

Background:

• Analyzes public debate on palliative care and euthanasia in the Netherlands.
• Examines cultural themes (frames and counter-frames) shaping perceptions of these intertwined topics.
• Identifies how frames influence problem definitions, consequences, and policy options.

Purpose of the Study:

• To identify and analyze the frames and counter-frames used in the public discourse surrounding palliative care and euthanasia.
• To understand the underlying reasoning and ideological patterns associated with different frames.
• To provide a comprehensive overview of perspectives for informed decision-making.

Main Methods:

• Inductive framing analysis of 2,700 text fragments from Dutch media and policy documents (2016-2018).
• Utilized thematic, axial, and selective coding, followed by peer review and expert member checking.
• Constructed seven frames and seven counter-frames for palliative care and euthanasia.

Main Results:

• Palliative care frames: 'Fear of death' and 'Heavy burden'; counter-frames: 'Quality of life' and 'Completion'.
• Euthanasia frames: 'Thou shalt not kill', 'Slippery slope', 'Lack of willpower', 'I am not God', 'Medical progress'.
• Euthanasia counter-frames: 'Mercy', 'Prevention', 'Triumph of reason', 'Absolute autonomy', 'Economic utility thinking'.

Conclusions:

• The debate transcends a simple pro/con dichotomy, revealing a plurality of viewpoints.
• Awareness of all frames is essential for audiences to make informed decisions.
• The frame matrix aids policymakers and healthcare workers in navigating public discourse and patient conversations.