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Exploring doctors' reasons for not granting a request for euthanasia: a mixed-methods study.

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Physicians declining physician-assisted death (PAD) requests cite concerns about legal criteria or specific patient groups. The Euthanasia Expertise Centre (EEC) provides an alternative for patients, and peer support can aid physicians navigating complex cases.

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euthanasiageneral practitionersqualitative researchsurveys and questionnaires

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Area of Science:

  • Medical Ethics
  • Palliative Care
  • End-of-Life Discussions

Background:

  • Physician-assisted death (PAD) is increasingly integrated into medical practice in various jurisdictions.
  • In the Netherlands, physicians can opt out of providing PAD, with the Euthanasia Expertise Centre (EEC) offering services to patients whose requests are declined.
  • An observed rise in referrals to the EEC suggests a lower threshold for physicians to refer patients.

Purpose of the Study:

  • To investigate the reasons behind physicians' refusal to grant PAD requests or refer patients to the EEC.
  • To identify physicians' needs when managing requests for PAD.

Main Methods:

  • A survey was distributed to 500 Dutch physicians who had declined a PAD request.
  • A subsequent qualitative study involved in-depth interviews with 21 survey respondents.
  • The study focused on physicians in The Netherlands.

Main Results:

  • Physicians' refusals stemmed from principled objections or concerns regarding adherence to due care criteria for PAD.
  • Difficulties were also reported in managing PAD requests for specific patient populations.
  • Many physicians expressed a need for support from other healthcare professionals.

Conclusions:

  • The EEC serves as a viable option for patients whose physicians have principled objections to PAD.
  • Physicians struggling with the legal requirements of PAD may benefit from peer support and guidance.