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Pressure in dealing with requests for euthanasia or assisted suicide. Experiences of general practitioners
  1. Marike E de Boer1,
  2. Marja F I A Depla1,
  3. Marjolein den Breejen1,
  4. Pauline Slottje1,
  5. Bregje D Onwuteaka-Philipsen2,
  6. Cees M P M Hertogh1
  1. 1 Department of General Practice and Old Age Medicine, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
  2. 2 Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
  1. Correspondence to Marike E de Boer, Department of General Practice and Elderly Care Medicine, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam 1081 HV, The Netherlands; m.deboer{at}vumc.nl

Abstract

The majority of Dutch physicians feel pressure when dealing with a request for euthanasia or physician-assisted suicide (EAS). This study aimed to explore the content of this pressure as experienced by general practitioners (GP). We conducted semistructured in-depth interviews with 15 Dutch GPs, focusing on actual cases. The interviews were transcribed and analysed with use of the framework method. Six categories of pressure GPs experienced in dealing with EAS requests were revealed: (1) emotional blackmail, (2) control and direction by others, (3) doubts about fulfilling the criteria, (4) counterpressure by patient’s relatives, (5) time pressure around referred patients and (6) organisational pressure. We conclude that the pressure can be attributable to the patient–physician relationship and/or the relationship between the physician and the patient’s relative(s), the inherent complexity of the decision itself and the circumstances under which the decision has to be made. To prevent physicians to cross their personal boundaries in dealing with EAS request all these different sources of pressure will have to be taken into account.

  • euthanasia
  • primary care
  • scientific research
  • suicide/assisted suicide
  • ethics
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Footnotes

  • Contributors MEdeB, CMPMH, BDOP and PS were involved in the proposal of the study. MEdeB conducted the interviews. MEdeB was involved in analysing the data, with assistance from MdenB and MFIAD. A first draft of the article was written by MEdeB with assistance from MFIAD. All other authors commented on the draft of the article which led to a revised version that was approved by all authors.

  • Funding This research was funded by the academic network of general practice of the department of general practice of Amsterdam UMC, Vrije Universiteit Amsterdam (ANH VUmc).

  • Competing interests None declared.

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

  • Patient consent for publication Not required.

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