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Belgian psychiatrists’ attitudes towards, and readiness to engage in, euthanasia assessment procedures with adults with psychiatric conditions : a survey

Monica Verhofstadt (UGent) , Kurt Audenaert (UGent) , Kris Van den Broeck, Luc Deliens (UGent) , Freddy Mortier (UGent) , Koen Titeca (UGent) , Koen Pardon (UGent) and Kenneth Chambaere (UGent)
(2020) BMC PSYCHIATRY. 20(1).
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Abstract
Background: Although the Belgian assessment pathway for legal euthanasia requires the engagement of at least one psychiatrist, little is known about psychiatrists’ attitudes towards euthanasia for adults with psychiatric conditions (APC). This study aims to gauge psychiatrists’ attitudes towards and readiness to engage in euthanasia assessment and/or performance procedures in APC. Methods: This cross-sectional survey study was performed between November 2018 and April 2019. The survey was sent to a sample of 499 eligible psychiatrists affiliated to the Flemish Association for Psychiatry, a professional association that aims to unite and represent all psychiatrists working in Flanders, the Dutch-speaking, northern part of Belgium. The Association’s members comprise an estimated 80–90% of all psychiatrists active in Flanders. Only psychiatrists working with APC (83% of the association’s total membership) were included. Factorial Anova and Chi Square tests were performed to examine if and to what extent psychiatrists’ backgrounds were associated with, respectively, their attitudes and their readiness to play a role in euthanasia procedures concerning APC. Results: One hundred eighty-four psychiatrists completed the questionnaire (response rate 40.2%); 74.5% agree that euthanasia should remain permissible for APC. However, 68.9% question some of the approaches taken by other physicians during the euthanasia assessment and only half consider euthanasia assessment procedures compatible with the psychiatric care relationship. Where active engagement is concerned, an informal referral (68%) or preliminary advisory role (43.8%) is preferred to a formal role as a legally required advising physician (30.3%), let alone as performing physician (< 10%). Conclusion: Although three quarters agree with maintaining the legal option of euthanasia for APC, their readiness to take a formal role in euthanasia procedures appears to be limited. More insight is required into the barriers preventing engagement and what psychiatrists need, be it education or clarification of the legal requirements, to ensure that patients can have their euthanasia requests assessed adequately.
Keywords
Psychiatry and Mental health, Euthanasia, Mental disorders, Assisted suicide, Psychiatry, Survey study, EoLC

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MLA
Verhofstadt, Monica, et al. “Belgian Psychiatrists’ Attitudes towards, and Readiness to Engage in, Euthanasia Assessment Procedures with Adults with Psychiatric Conditions : A Survey.” BMC PSYCHIATRY, vol. 20, no. 1, 2020, doi:10.1186/s12888-020-02775-x.
APA
Verhofstadt, M., Audenaert, K., Van den Broeck, K., Deliens, L., Mortier, F., Titeca, K., … Chambaere, K. (2020). Belgian psychiatrists’ attitudes towards, and readiness to engage in, euthanasia assessment procedures with adults with psychiatric conditions : a survey. BMC PSYCHIATRY, 20(1). https://doi.org/10.1186/s12888-020-02775-x
Chicago author-date
Verhofstadt, Monica, Kurt Audenaert, Kris Van den Broeck, Luc Deliens, Freddy Mortier, Koen Titeca, Koen Pardon, and Kenneth Chambaere. 2020. “Belgian Psychiatrists’ Attitudes towards, and Readiness to Engage in, Euthanasia Assessment Procedures with Adults with Psychiatric Conditions : A Survey.” BMC PSYCHIATRY 20 (1). https://doi.org/10.1186/s12888-020-02775-x.
Chicago author-date (all authors)
Verhofstadt, Monica, Kurt Audenaert, Kris Van den Broeck, Luc Deliens, Freddy Mortier, Koen Titeca, Koen Pardon, and Kenneth Chambaere. 2020. “Belgian Psychiatrists’ Attitudes towards, and Readiness to Engage in, Euthanasia Assessment Procedures with Adults with Psychiatric Conditions : A Survey.” BMC PSYCHIATRY 20 (1). doi:10.1186/s12888-020-02775-x.
Vancouver
1.
Verhofstadt M, Audenaert K, Van den Broeck K, Deliens L, Mortier F, Titeca K, et al. Belgian psychiatrists’ attitudes towards, and readiness to engage in, euthanasia assessment procedures with adults with psychiatric conditions : a survey. BMC PSYCHIATRY. 2020;20(1).
IEEE
[1]
M. Verhofstadt et al., “Belgian psychiatrists’ attitudes towards, and readiness to engage in, euthanasia assessment procedures with adults with psychiatric conditions : a survey,” BMC PSYCHIATRY, vol. 20, no. 1, 2020.
@article{8671526,
  abstract     = {{Background: Although the Belgian assessment pathway for legal euthanasia requires the engagement of at least one psychiatrist, little is known about psychiatrists’ attitudes towards euthanasia for adults with psychiatric conditions (APC). This study aims to gauge psychiatrists’ attitudes towards and readiness to engage in euthanasia assessment and/or performance procedures in APC.

Methods: This cross-sectional survey study was performed between November 2018 and April 2019. The survey was sent to a sample of 499 eligible psychiatrists affiliated to the Flemish Association for Psychiatry, a professional association that aims to unite and represent all psychiatrists working in Flanders, the Dutch-speaking, northern part of Belgium. The Association’s members comprise an estimated 80–90% of all psychiatrists active in Flanders. Only psychiatrists working with APC (83% of the association’s total membership) were included. Factorial Anova and Chi Square tests were performed to examine if and to what extent psychiatrists’ backgrounds were associated with, respectively, their attitudes and their readiness to play a role in euthanasia procedures concerning APC.

Results: One hundred eighty-four psychiatrists completed the questionnaire (response rate 40.2%); 74.5% agree that euthanasia should remain permissible for APC. However, 68.9% question some of the approaches taken by other physicians during the euthanasia assessment and only half consider euthanasia assessment procedures compatible with the psychiatric care relationship. Where active engagement is concerned, an informal referral (68%) or preliminary advisory role (43.8%) is preferred to a formal role as a legally required advising physician (30.3%), let alone as performing physician (< 10%).

Conclusion: Although three quarters agree with maintaining the legal option of euthanasia for APC, their readiness to take a formal role in euthanasia procedures appears to be limited. More insight is required into the barriers preventing engagement and what psychiatrists need, be it education or clarification of the legal requirements, to ensure that patients can have their euthanasia requests assessed adequately.}},
  articleno    = {{374}},
  author       = {{Verhofstadt, Monica and Audenaert, Kurt and Van den Broeck, Kris and Deliens, Luc and Mortier, Freddy and Titeca, Koen and Pardon, Koen and Chambaere, Kenneth}},
  issn         = {{1471-244X}},
  journal      = {{BMC PSYCHIATRY}},
  keywords     = {{Psychiatry and Mental health,Euthanasia,Mental disorders,Assisted suicide,Psychiatry,Survey study,EoLC}},
  language     = {{eng}},
  number       = {{1}},
  pages        = {{10}},
  title        = {{Belgian psychiatrists’ attitudes towards, and readiness to engage in, euthanasia assessment procedures with adults with psychiatric conditions : a survey}},
  url          = {{http://doi.org/10.1186/s12888-020-02775-x}},
  volume       = {{20}},
  year         = {{2020}},
}

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