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Are general practitioners prepared to end life on request in a country where euthanasia is legalised?

Marij Sercu (UGent), Peter Pype (UGent), Thierry Christiaens (UGent), Maria Grypdonck (UGent), Anselme Derese (UGent) and Myriam Deveugele (UGent)
(2012) JOURNAL OF MEDICAL ETHICS. 38(5). p.274-280
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Organization
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.
Keywords
MEDICAL-PRACTICE, PALLIATIVE CARE, NETHERLANDS, PHYSICIANS, BELGIUM, DOCTORS

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Chicago
Sercu, Marij, Peter Pype, Thierry Christiaens, Maria Grypdonck, Anselme Derese, and Myriam Deveugele. 2012. “Are General Practitioners Prepared to End Life on Request in a Country Where Euthanasia Is Legalised?” Journal of Medical Ethics 38 (5): 274–280.
APA
Sercu, M., Pype, P., Christiaens, T., Grypdonck, M., Derese, A., & Deveugele, M. (2012). Are general practitioners prepared to end life on request in a country where euthanasia is legalised? JOURNAL OF MEDICAL ETHICS, 38(5), 274–280.
Vancouver
1.
Sercu M, Pype P, Christiaens T, Grypdonck M, Derese A, Deveugele M. Are general practitioners prepared to end life on request in a country where euthanasia is legalised? JOURNAL OF MEDICAL ETHICS. 2012;38(5):274–80.
MLA
Sercu, Marij, Peter Pype, Thierry Christiaens, et al. “Are General Practitioners Prepared to End Life on Request in a Country Where Euthanasia Is Legalised?” JOURNAL OF MEDICAL ETHICS 38.5 (2012): 274–280. Print.
@article{1997680,
  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.},
  author       = {Sercu, Marij and Pype, Peter and Christiaens, Thierry and Grypdonck, Maria and Derese, Anselme and Deveugele, Myriam},
  issn         = {0306-6800},
  journal      = {JOURNAL OF MEDICAL ETHICS},
  keyword      = {MEDICAL-PRACTICE,PALLIATIVE CARE,NETHERLANDS,PHYSICIANS,BELGIUM,DOCTORS},
  language     = {eng},
  number       = {5},
  pages        = {274--280},
  title        = {Are general practitioners prepared to end life on request in a country where euthanasia is legalised?},
  url          = {http://dx.doi.org/10.1136/medethics-2011-100048},
  volume       = {38},
  year         = {2012},
}

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