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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
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.
Please use this url to cite or link to this publication:
author
organization
year
type
journalArticle (original)
publication status
published
subject
keyword
MEDICAL-PRACTICE, PALLIATIVE CARE, NETHERLANDS, PHYSICIANS, BELGIUM, DOCTORS
journal title
JOURNAL OF MEDICAL ETHICS
J. Med. Ethics
volume
38
issue
5
pages
274 - 280
Web of Science type
Article
Web of Science id
000303759700004
JCR category
ETHICS
JCR impact factor
1.419 (2012)
JCR rank
9/48 (2012)
JCR quartile
1 (2012)
ISSN
0306-6800
DOI
10.1136/medethics-2011-100048
language
English
UGent publication?
yes
classification
A1
copyright statement
I have transferred the copyright for this publication to the publisher
id
1997680
handle
http://hdl.handle.net/1854/LU-1997680
date created
2012-01-20 09:19:53
date last changed
2015-06-17 09:54:48
@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},
}

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.