How do general practitioners assess the criteria for due care for euthanasia in concrete cases?

Health Policy. 2008 Sep;87(3):316-25. doi: 10.1016/j.healthpol.2007.12.009. Epub 2008 Mar 7.

Abstract

Objective: In the Netherlands the law states that physicians are allowed to grant a request for euthanasia or physician-assisted suicide (EAS) if specific criteria for due care are met. This study investigated which sources physicians use to determine whether three of these criteria (unbearable and hopeless suffering, and no realistic alternatives for treatment) are met.

Methods: The data were collected for the project Support and Consultation on Euthanasia in the Netherlands. General practitioners (GPs) received a written questionnaire concerning the most recent request for EAS that they had received. Of the 3614 (60%) GPs who returned the questionnaire, 1681 described the most recent request for EAS.

Results: The study shows that physicians used different types of sources, and more than one source, to determine whether the criteria were met. More sources were used when the criteria were met or when a request resulted in EAS. The determination of every criterion required a different approach, but for all criteria discussions with colleagues were important.

Conclusions: Using less sources when a criterion is not met could possibly lead to less extensive consideration of the criteria, and therefore to assessing too easily that the request does not meet the criteria for due care.

MeSH terms

  • Adult
  • Data Collection
  • Decision Making*
  • Euthanasia / legislation & jurisprudence*
  • Euthanasia / statistics & numerical data
  • Female
  • Guideline Adherence / statistics & numerical data*
  • Humans
  • Information Services / classification*
  • Information Services / statistics & numerical data
  • Interprofessional Relations
  • Male
  • Medical Futility
  • Middle Aged
  • Netherlands
  • Pain
  • Physician-Patient Relations
  • Physicians, Family / education
  • Physicians, Family / legislation & jurisprudence
  • Physicians, Family / standards*
  • Professional Competence / statistics & numerical data*
  • Suicide, Assisted / legislation & jurisprudence*
  • Suicide, Assisted / statistics & numerical data
  • Surveys and Questionnaires
  • Terminal Care / standards*