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The impact of the euthanasia assessment procedure : a qualitative interview study among adults with psychiatric conditions

Monica Verhofstadt (UGent) , Kenneth Chambaere (UGent) , Koen Pardon (UGent) , Freddy Mortier (UGent) , Axel Liegeois, Luc Deliens (UGent) and Kurt Audenaert (UGent)
(2022) BMC PSYCHIATRY. 22(1).
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Abstract
Background Assisted dying for adults with psychiatric conditions (APC) is highly controversial but legally possible in a few countries, including Belgium. Previous research has suggested that the complex euthanasia assessment procedure may cause additional suffering in APC but may also induce positive experiences. This study reports on the impact of the euthanasia assessment procedure as experienced by APC on three counts: 1) their mental state, including death ideation; 2) their treatment trajectory; 3) their social relationships. Methods We performed an in-depth qualitative interview study with 16 APC in Flanders, Belgium, who had voiced a euthanasia request between 2016-2020. Thematic coding was used. Findings We interviewed 16 APC. Euthanasia assessment procedures brought out a plethora of experiences in APC, both favourable and unfavourable. Whereas thoughts of suicide remain present to a certain extent, being in the assessment procedure allows some APC to reconsider alternatives towards life, and also to attempt new treatment options. However, many APC experience ambivalence about the supposedly inherent desirability and dignity in euthanasia. Worries also surfaced about the rationale behind and effects of involvement of APCs' social circle, and about the impact it could have on them. Conclusion Further research, including other stakeholder perspectives, is recommended with a view to maximising favourable and minimising unfavourable impacts for all involved. In clinical practice attention to these impacts is paramount, and clear communication and management of expectations between physician and patient, seems appropriate to address the many ambivalent experiences that accompany APC during the euthanasia assessment procedure. Policy attention could in this regard go to clarifying certain sources of ambivalence and issues that are insufficiently addressed, such as modalities of relatives' involvement.
Keywords
REQUEST EUTHANASIA, PERSPECTIVES, PHYSICIANS, Euthanasia, Mental disorders, End-of-life decisions, Assisted suicide

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MLA
Verhofstadt, Monica, et al. “The Impact of the Euthanasia Assessment Procedure : A Qualitative Interview Study among Adults with Psychiatric Conditions.” BMC PSYCHIATRY, vol. 22, no. 1, 2022, doi:10.1186/s12888-022-04039-2.
APA
Verhofstadt, M., Chambaere, K., Pardon, K., Mortier, F., Liegeois, A., Deliens, L., & Audenaert, K. (2022). The impact of the euthanasia assessment procedure : a qualitative interview study among adults with psychiatric conditions. BMC PSYCHIATRY, 22(1). https://doi.org/10.1186/s12888-022-04039-2
Chicago author-date
Verhofstadt, Monica, Kenneth Chambaere, Koen Pardon, Freddy Mortier, Axel Liegeois, Luc Deliens, and Kurt Audenaert. 2022. “The Impact of the Euthanasia Assessment Procedure : A Qualitative Interview Study among Adults with Psychiatric Conditions.” BMC PSYCHIATRY 22 (1). https://doi.org/10.1186/s12888-022-04039-2.
Chicago author-date (all authors)
Verhofstadt, Monica, Kenneth Chambaere, Koen Pardon, Freddy Mortier, Axel Liegeois, Luc Deliens, and Kurt Audenaert. 2022. “The Impact of the Euthanasia Assessment Procedure : A Qualitative Interview Study among Adults with Psychiatric Conditions.” BMC PSYCHIATRY 22 (1). doi:10.1186/s12888-022-04039-2.
Vancouver
1.
Verhofstadt M, Chambaere K, Pardon K, Mortier F, Liegeois A, Deliens L, et al. The impact of the euthanasia assessment procedure : a qualitative interview study among adults with psychiatric conditions. BMC PSYCHIATRY. 2022;22(1).
IEEE
[1]
M. Verhofstadt et al., “The impact of the euthanasia assessment procedure : a qualitative interview study among adults with psychiatric conditions,” BMC PSYCHIATRY, vol. 22, no. 1, 2022.
@article{8763248,
  abstract     = {{Background Assisted dying for adults with psychiatric conditions (APC) is highly controversial but legally possible in a few countries, including Belgium. Previous research has suggested that the complex euthanasia assessment procedure may cause additional suffering in APC but may also induce positive experiences. This study reports on the impact of the euthanasia assessment procedure as experienced by APC on three counts: 1) their mental state, including death ideation; 2) their treatment trajectory; 3) their social relationships. Methods We performed an in-depth qualitative interview study with 16 APC in Flanders, Belgium, who had voiced a euthanasia request between 2016-2020. Thematic coding was used. Findings We interviewed 16 APC. Euthanasia assessment procedures brought out a plethora of experiences in APC, both favourable and unfavourable. Whereas thoughts of suicide remain present to a certain extent, being in the assessment procedure allows some APC to reconsider alternatives towards life, and also to attempt new treatment options. However, many APC experience ambivalence about the supposedly inherent desirability and dignity in euthanasia. Worries also surfaced about the rationale behind and effects of involvement of APCs' social circle, and about the impact it could have on them. Conclusion Further research, including other stakeholder perspectives, is recommended with a view to maximising favourable and minimising unfavourable impacts for all involved. In clinical practice attention to these impacts is paramount, and clear communication and management of expectations between physician and patient, seems appropriate to address the many ambivalent experiences that accompany APC during the euthanasia assessment procedure. Policy attention could in this regard go to clarifying certain sources of ambivalence and issues that are insufficiently addressed, such as modalities of relatives' involvement.}},
  articleno    = {{435}},
  author       = {{Verhofstadt, Monica and Chambaere, Kenneth and Pardon, Koen and Mortier, Freddy and Liegeois, Axel and Deliens, Luc and Audenaert, Kurt}},
  issn         = {{1471-244X}},
  journal      = {{BMC PSYCHIATRY}},
  keywords     = {{REQUEST EUTHANASIA,PERSPECTIVES,PHYSICIANS,Euthanasia,Mental disorders,End-of-life decisions,Assisted suicide}},
  language     = {{eng}},
  number       = {{1}},
  pages        = {{15}},
  title        = {{The impact of the euthanasia assessment procedure : a qualitative interview study among adults with psychiatric conditions}},
  url          = {{http://doi.org/10.1186/s12888-022-04039-2}},
  volume       = {{22}},
  year         = {{2022}},
}

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