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Are general practitioners prepared to end life on request in a country where euthanasia is legalised?
  1. M Sercu1,
  2. P Pype1,
  3. T Christiaens1,
  4. M Grypdonck2,
  5. A Derese1,
  6. M Deveugele1
  1. 1Department of General Practice and Primary Health Care, Ghent University, Ghent, Belgium
  2. 2Department of Nursing, Ghent University, Ghent, Belgium
  1. Correspondence to Dr M Sercu, Department of General Practice and Primary Health Care, University Hospital 1K3, De Pintelaan 185, 9000 Ghent, Belgium; maria.sercu{at}ugent.be

Abstract

Background In 2002, Belgium set a legal framework for euthanasia, whereby granting and performing euthanasia is entrusted entirely to physicians, and—as advised by Belgian Medical Deontology—in the context of a trusted patient–physician relationship. Euthanasia is, however, rarely practiced, so the average physician will not attain routine in this matter.

Aim To explore how general practitioners in Flanders (Belgium) deal with euthanasia. This was performed via qualitative analysis of semistructured interviews with 52 general practitioners (GPs).

Results Although GPs can understand a patient's request for euthanasia, their own willingness to perform it is limited, based on their assumption that legal euthanasia equates to an injection that ends life abruptly. Their willingness to perform euthanasia is affected by the demanding nature of a patient's request, by their views on what circumstances render euthanasia legitimate and by their own ability to inject a lethal dose. Several GPs prefer increasing opioid dosages and palliative sedation to a lethal injection, which they consider to fall outside the scope of euthanasia legislation.

Conclusions Four attitudes can be identified: (1) willing to perform euthanasia; (2) only willing to perform as a last resort; (3) feeling incapable of performing; (4) refusing on principle. The situation where GPs have to consider the request and—if they grant it—to perform the act may result in arbitrary access to euthanasia for the patient. The possibility of installing transparent referral and support strategies for the GPs should be further examined. Further discussion is needed in the medical profession about the exact content of the euthanasia law.

  • General practice
  • end-of-life practices
  • euthanasia decision-making
  • euthanasia
  • care of the dying patient
  • primary care
  • drugs and drug industry
  • elderly and terminally ill
  • primary care
  • public health ethics
  • education for health care professionals
  • euthanasia

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Footnotes

  • Competing interests None.

  • Ethics approval The study received approval from the ethics committee of the University Hospital of Ghent University EC Project No.: 2007/084. Belgian Registration No.: B67020071901.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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