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Euthanasia requests in dementia cases; what are experiences and needs of Dutch physicians? A qualitative interview study

Bibliographic Details
Title: Euthanasia requests in dementia cases; what are experiences and needs of Dutch physicians? A qualitative interview study
Authors: Jaap Schuurmans, Romy Bouwmeester, Lamar Crombach, Tessa van Rijssel, Lizzy Wingens, Kristina Georgieva, Nadine O’Shea, Stephanie Vos, Bram Tilburgs, Yvonne Engels
Source: BMC Medical Ethics, Vol 20, Iss 1, Pp 1-9 (2019)
Subject Terms: Euthanasia, Dementia, Elderly, Elderly care physician general practitioners, Primary care, Support, Medical philosophy. Medical ethics, R723-726
Publisher Information: BMC, 2019.
Publication Year: 2019
Collection: LCC:Medical philosophy. Medical ethics
Description: Abstract Background In the Netherlands, in 2002, euthanasia became a legitimate medical act, only allowed when the due care criteria and procedural requirements are met. Legally, an Advanced Euthanasia Directive (AED) can replace direct communication if a patient can no longer express his own wishes. In the past decade, an exponential number of persons with dementia (PWDs) share a euthanasia request with their physician. The impact this on physicians, and the consequent support needs, remained unknown. Our objective was to gain more insight into the experiences and needs of Dutch general practitioners and elderly care physicians when handling a euthanasia request from a person with dementia (PWD). Methods We performed a qualitative interview study. Participants were recruited via purposive sampling. The interviews were transcribed verbatim, and analyzed using the conventional thematic content analysis. Results Eleven general practitioners (GPs) and elderly care physicians with a variety of experience and different attitudes towards euthanasia for PWD were included. Euthanasia requests appeared to have a major impact on physicians. Difficulties they experienced were related to timing, workload, pressure from and expectations of relatives, society’s negative view of dementia in combination with the ‘right to die’ view, the interpretation of the law and AEDs, ethical considerations, and communication with PWD and relatives. To deal with these difficulties, participants need support from colleagues and other professionals. Although elderly care physicians appreciated moral deliberation and support by chaplains, this was hardly mentioned by GPs. Conclusions Euthanasia requests in dementia seem to place an ethically and emotionally heavy burden on Dutch GPs and elderly care physicians. The awareness of, and access to, existing and new support mechanisms needs further exploration.
Document Type: article
File Description: electronic resource
Language: English
ISSN: 1472-6939
Relation: http://link.springer.com/article/10.1186/s12910-019-0401-y; https://doaj.org/toc/1472-6939
DOI: 10.1186/s12910-019-0401-y
Access URL: https://doaj.org/article/d1c0039e13c04f5d885f57a20ae4f96e
Accession Number: edsdoj.1c0039e13c04f5d885f57a20ae4f96e
ISSN: 14726939
DOI: 10.1186/s12910-019-0401-y
Database: Directory of Open Access Journals