A qualitative focus group study on legal experts' views regarding euthanasia requests based on an advance euthanasia...

Area of Science:

• Medical Law
• Bioethics
• Geriatric Medicine

Background:

• The Dutch Euthanasia law allows euthanasia for advanced dementia patients lacking decisional capacity, based on advance directives.
• Physicians face challenges in applying due care criteria in these complex cases.

Purpose of the Study:

• To explore legal experts' perspectives on fulfilling due care criteria for euthanasia in advanced dementia.
• To identify needs for additional legal guidance to support physicians' decision-making.

Main Methods:

• Qualitative study involving legal experts.
• Two focus group sessions were conducted.
• Thematic content analysis and framework method were used for data interpretation.

Main Results:

• Legal experts emphasize considering current patient wishes alongside advance euthanasia directives.
• Physicians are responsible for interpreting both directives and current expressions, despite challenges with changing preferences and assessing suffering.
• Differing views exist on prioritizing life wishes over advance directives in dementia patients.

Conclusions:

• Due care criteria in the Dutch Euthanasia law are open norms requiring case-by-case interpretation by physicians.
• Physicians bear the responsibility for interpreting advance directives and patient expressions, with limited additional legal support.
• There is a need for clearer legal guidance to aid physicians in complex euthanasia decisions for dementia patients.