Article Text

Download PDFPDF
Old problems in need of new (narrative) approaches? A young physician–bioethicist’s search for ethical guidance in the practice of physician-assisted dying in the Netherlands
  1. Bernadette Roest
  1. Department of Care Ethics, University of Humanistic Studies, Utrecht, The Netherlands
  1. Correspondence to Mrs Bernadette Roest, Department of Care Ethics, University of Humanistic Studies, Kromme Nieuwegracht 29, 3512HD Utrecht, The Netherlands; bernadette.roest{at}


The current empirical research and normative arguments on physician-assisted dying (PAD) in the Netherlands seem insufficient to provide ethical guidance to general practitioners in the practice of PAD, due to a gap between the evidence and arguments on the one hand and the uncertainties and complexities as found in everyday practice on the other. This paper addresses the problems of current ethical arguments and empirical research and how both seem to be profoundly influenced by the Dutch legislative framework on PAD and a certain view on ethics. Furthermore, the paper elaborates on how other approaches to empirical research in bioethics, such as found in the broad field of narrative research, could supplement the empirical and ethical evaluation of PAD in the Netherlands. This paper also addresses the challenging question of how empirical data—in this case narratives—relate to normativity. The paper is written in the form of a personal narrative of the author, a young Dutch general practitioner and researcher in bioethics. This style is intentionally chosen, to illustrate how work context and professional background influence the observations one makes and the questions one may ask about the topic of PAD. In addition, by using this style, this paper not only gives a different perspective on a much-contested bioethical issue, but also on the challenges faced when a physician–bioethicist has to navigate different disciplinary fields and (moral) epistemological paradigms, especially since the ‘empirical turn’ in bioethics.

  • euthanasia
  • end-of-life

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.


  • Correction notice This article has been amended since it was first published online. Footnote ii and reference 32 have been updated.

  • Contributors BR was the sole author involved in drafting and writing the manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests No competing interests.

  • Patient consent for publication Not required.

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

  • Author note I obtained my medical degree at the University of Leiden (the Netherlands) in 2011 and pursued a 3-year general practice vocational training at the same university. In addition, I obtained the joint Erasmus Mundus Master of Bioethics degree from the KU Leuven (Belgium), Radboud University (the Netherlands) and the University of Padua (Italy). After several years of working as a general practitioner, I started a doctoral research at the department of Care Ethics of the University of Humanistic studies in Utrecht, the Netherlands. As part of my doctoral research, I follow an online certification program about Narrative Medicine at Columbia University NYC.

Other content recommended for you