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Research

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

Caroline van den Ende, Eveline Margaretha Bunge, Jennifer Eeuwijk and Suzanne van de Vathorst
BJGP Open 2022; 6 (4): BJGPO.2022.0015. DOI: https://doi.org/10.3399/BJGPO.2022.0015
Caroline van den Ende
1 Pallas Health Research and Consultancy BV, Rotterdam, The Netherlands
2 Department of General Practice/Family Medicine, Amsterdam UMC, Amsterdam, The Netherlands
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  • ORCID record for Caroline van den Ende
  • For correspondence: c.vandenende@amsterdamumc.nl
Eveline Margaretha Bunge
1 Pallas Health Research and Consultancy BV, Rotterdam, The Netherlands
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Jennifer Eeuwijk
1 Pallas Health Research and Consultancy BV, Rotterdam, The Netherlands
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Suzanne van de Vathorst
3 Department of Ethics, Law and Medical Humanities, Amsterdam UMC, Amsterdam, The Netherlands
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Article Figures & Data

Tables

    • View popup
    Table 1. Background characteristics of responders (n = 116)
    Characteristicn (%)
    Specialism
     GP95 (81.9)
     Clinical specialist0 (0)
     Geriatric care physician20 (17.2)
     Psychiatrist0 (0)
     Junior doctor1 (0.9)
    Age
     ≤35 years19 (16.4)
     36–45 years40 (34.5)
     46–55 years23 (19.8)
     ≥56 years34 (29.3)
    Years of working experience
     ≤5 years9 (7.8)
     6–10 years30 (25.9)
     11–15 years22 (19.0)
     >15 years55 (47.4)
    Experience with requests for PADa
     Yes109 (94.0)
     No7 (6.0)
    Experience with performing PAD
     Yes74 (67.9)
     No35 (32.1)
    Number of times that PAD was performed (n = 74)
     110 (13.5)
     2–525 (33.8)
     >539 (52.7)
    • PAD = physician-assisted death. aExperience with requests for PAD other than the one discussed in the survey.

    • View popup
    Table 2. Background cases and reasons for not granting the request (n = 116)
    n (%)
    Underlying conditiona  
     Cancer32 (27.6)
     Other somatic disorders21 (18.1)
     Dementia17 (14.7)
     Psychiatric disorders11 (9.5)
     Accumulation of old-age complaints41 (35.3)
     Medical diagnosis not clear9 (7.8)
     Other conditions10 (8.6)
    Reasons for the treating physician not to grant the requestb  
     I have general objections against PAD20 (17.2)
     I do not want to perform PAD16 (13.8)
     I found the performance of PAD emotionally too distressing13 (11.2)
     There was not a good patient—physician relationship15 (12.9)
     I had doubts concerning the fulfilment of the criteria of due care49 (42.2)
     I was reluctant with the performance of PAD because I feared possible criminal/legal consequences11 (9.5)
     The performance of PAD should be solely in the hands of EEC3 (2.6)
     Other reasons32 (27.6)
    Has the treating physician referred the patient to a colleague? 
     Yes26 (22.4)
     No90 (77.6)
    Has the treating physician contacted a consultant working for EEC? 
     Yes38 (32.8)
     No78 (67.2)
    Has the treating physician consulted a SCEN-physician? 
     Yes16 (13.8)
     No100 (86.2)
    Has the treating physician consulted someone else? 
     Yes36 (31.0)
     No80 (69.0)
    Has the treating physician referred the patient to EEC? 
     Yes92 (79.3)
     No24 (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

    • View popup
    Table 3. Future requests for PAD
    n (%)
    Do you think you are willing (to continue) to perform PAD in the future?
     Yes, certainly or probably74 (63.8)
     No, certainly or probably not31 (26.7)
     Don’t know11 (9.5)
    Do you need support in handling requests for PAD? (n = 85)
     Yes35 (41.2)
     No50 (58.8)
    In which areas would you need support?a (n = 35)
     Dealing with pressure from patients to grant a request12 (34.3)
     Dealing with pressure from relatives of the patient10 (28.6)
     Assessment of unbearable suffering13 (37.1)
     The legal framework for PAD6 (17.1)
     PAD in specific patient groups (dementia, completed life, psychiatric)27 (77.1)
     Other4 (11.4)
    Who would you like to ask for support?a (n = 35)
     SCEN-physician22 (62.9)
     Consultant EEC30 (85.7)
     Colleague19 (54.3)
     Lawyer4 (11.4)
     Trainer0 (0)
     Other1 (2.9)
    • EEC = Euthanasia Expertise Centre. PAD = physician-assisted dying. SCEN = Support and Consultation in Euthanasia in The Netherlands. aMultiple answers possible

Supplementary Data

  • vdE_BJGPO.2022.0015_Supp.pdf -

    Supplementary material is not copyedited or typeset, and is published as supplied by the author(s). The author(s) retain(s) responsibility for its accuracy.

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Exploring doctors’ reasons for not granting a request for euthanasia: a mixed-methods study
Caroline van den Ende, Eveline Margaretha Bunge, Jennifer Eeuwijk, Suzanne van de Vathorst
BJGP Open 2022; 6 (4): BJGPO.2022.0015. DOI: 10.3399/BJGPO.2022.0015

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Exploring doctors’ reasons for not granting a request for euthanasia: a mixed-methods study
Caroline van den Ende, Eveline Margaretha Bunge, Jennifer Eeuwijk, Suzanne van de Vathorst
BJGP Open 2022; 6 (4): BJGPO.2022.0015. DOI: 10.3399/BJGPO.2022.0015
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Keywords

  • euthanasia
  • Surveys and Questionnaires
  • qualitative research
  • general practitioners

More in this TOC Section

  • Pattern of oral anticoagulant prescribing for atrial fibrillation in general practice: an observational study in The Netherlands
  • Translating primary care to telehealth: analysis of in-person consultations on diabetes and cardiovascular disease
  • Primary care physicians’ perceptions of social determinants of health recommendations: a qualitative study
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