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Reasons of doctors for not granting a request for euthanasia : mixed-methods study
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Background: In many jurisdictions physician-assisted death (PAD) is now an established part of medical care. Although PAD is allowed under certain criteria in the Netherlands, physicians can always refuse a request. Euthanasia Expertise Centre (EEC) offers PAD to patients whose request was declined, although their own physician could meet the legal criteria. The number of requests reaching EEC increased, suggesting the threshold for treating physicians to refer a patient to EEC is lowered.
Aim: To explore the reasons of physicians for not granting a request for PAD and/or referring a patient to EEC, and any needs physicians may have in handling requests for PAD.
Design and Setting: Survey and interviews among Dutch physicians.
Method: A questionnaire was sent to 500 physicians who declined a request for PAD and whose patient subsequently requested PAD at EEC. This was followed by a qualitative study, in which we held in-depth interviews with 21 physicians who responded to the survey.
Results: We identified doctors who had principal objections, and doctors with other reasons to refuse a request for PAD and/or to refer the patient to EEC. These reasons were mostly related to concerns about complying with the due care criteria for PAD, or to difficulties with PAD in specific patient groups. In these cases they often valued support from another healthcare professional.
Conclusion: For patients of physicians with principal objections against PAD, EEC offers a good solution. Doctors who struggle with whether they can comply with the legal criteria, might benefit from peer support.
http://dx.doi.org/10.3399/BJGPO.2022.0015
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