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The role of the social network in active euthanasia and physician-assisted suicide
M T Muller1, B D Onwuteaka-Philipsen, G van der Wal
1Vrije Universiteit Amsterdam, Institute for Research in Extramural Medicine, The Netherlands.
Objective:
To obtain insight into the involvement of a patient's social network in the process leading to the administration of euthanasia and assisted suicide (EAS).
Design:
Descriptive, retrospective.
Method:
Data were collected by means of anonymous questionnaires sent to a random sample of 521 general practitioners (GPs) in the Province of North Holland and 521 GPs from the rest of the Netherlands and all 713 Dutch nursing home physicians (NHPs). The data were collected over the period 1986 to June 1990 inclusive.
Results:
GPs and NHPs had discussions most often with the partner of the patient about the patient's request for EAS, the doctor's intention to administer EAS and the actual administering of EAS. According to both the GPs and the NHPs the social network practically always agreed with the doctor's decision to administer EAS. The persons who were most often present at the patient's bedside when EAS was administered were the patient's partner and children (29%). Often, especially in the cases of GPs, the decision not to report EAS was determined by the desire of relatives and/or the physician not to involve the relatives in a judicial inquiry.
Conclusion:
To a large extent the social network was involved in the patient's request for EAS, the doctor's intention to administer EAS and the actual administering of EAS. This seems to be important both for good decision-making with regard to EAS and for helping relatives to come to terms with the loss of a dear one.