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

Article Figures & Data

Table 1. Background characteristics of responders (n = 116)

Characteristic	n (%)
Specialism
GP	95 (81.9)
Clinical specialist	0 (0)
Geriatric care physician	20 (17.2)
Psychiatrist	0 (0)
Junior doctor	1 (0.9)
Age
≤35 years	19 (16.4)
36–45 years	40 (34.5)
46–55 years	23 (19.8)
≥56 years	34 (29.3)
Years of working experience
≤5 years	9 (7.8)
6–10 years	30 (25.9)
11–15 years	22 (19.0)
>15 years	55 (47.4)
Experience with requests for PAD^a
Yes	109 (94.0)
No	7 (6.0)
Experience with performing PAD
Yes	74 (67.9)
No	35 (32.1)
Number of times that PAD was performed (n = 74)
1	10 (13.5)
2–5	25 (33.8)
>5	39 (52.7)

PAD = physician-assisted death. ^aExperience with requests for PAD other than the one discussed in the survey.

Table 2. Background cases and reasons for not granting the request (n = 116)

	n (%)
Underlying condition^a
Cancer	32 (27.6)
Other somatic disorders	21 (18.1)
Dementia	17 (14.7)
Psychiatric disorders	11 (9.5)
Accumulation of old-age complaints	41 (35.3)
Medical diagnosis not clear	9 (7.8)
Other conditions	10 (8.6)
Reasons for the treating physician not to grant the request^b
I have general objections against PAD	20 (17.2)
I do not want to perform PAD	16 (13.8)
I found the performance of PAD emotionally too distressing	13 (11.2)
There was not a good patient—physician relationship	15 (12.9)
I had doubts concerning the fulfilment of the criteria of due care	49 (42.2)
I was reluctant with the performance of PAD because I feared possible criminal/legal consequences	11 (9.5)
The performance of PAD should be solely in the hands of EEC	3 (2.6)
Other reasons	32 (27.6)
Has the treating physician referred the patient to a colleague?
Yes	26 (22.4)
No	90 (77.6)
Has the treating physician contacted a consultant working for EEC?
Yes	38 (32.8)
No	78 (67.2)
Has the treating physician consulted a SCEN-physician?
Yes	16 (13.8)
No	100 (86.2)
Has the treating physician consulted someone else?
Yes	36 (31.0)
No	80 (69.0)
Has the treating physician referred the patient to EEC?
Yes	92 (79.3)
No	24 (20.7)

EEC = Euthanasia Expertise Centre. PAD = physician-assisted dying. SCEN = Support and Consultation in Euthanasia in The Netherlands. ^aMultiple answers possible. ^bMultiple answers possible; responders were asked to select a maximum of three answers

Table 3. Future requests for PAD

	n (%)
Do you think you are willing (to continue) to perform PAD in the future?
Yes, certainly or probably	74 (63.8)
No, certainly or probably not	31 (26.7)
Don’t know	11 (9.5)
Do you need support in handling requests for PAD? (n = 85)
Yes	35 (41.2)
No	50 (58.8)
In which areas would you need support?^a (n = 35)
Dealing with pressure from patients to grant a request	12 (34.3)
Dealing with pressure from relatives of the patient	10 (28.6)
Assessment of unbearable suffering	13 (37.1)
The legal framework for PAD	6 (17.1)
PAD in specific patient groups (dementia, completed life, psychiatric)	27 (77.1)
Other	4 (11.4)
Who would you like to ask for support?^a (n = 35)
SCEN-physician	22 (62.9)
Consultant EEC	30 (85.7)
Colleague	19 (54.3)
Lawyer	4 (11.4)
Trainer	0 (0)
Other	1 (2.9)

EEC = Euthanasia Expertise Centre. PAD = physician-assisted dying. SCEN = Support and Consultation in Euthanasia in The Netherlands. ^aMultiple answers possible

vdE_BJGPO.2022.0015_Supp.pdf -
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