Dealing with requests for euthanasia: Interview study among general practitioners in Belgium

Context In many countries physicians are confronted with requests for euthanasia. Notwithstanding euthanasia is legally permitted in Belgium, it remains the subject of intense debate.
Objective To gather in-depth empirical data on how GPs deal with these requests in Belgium.
Methods Mortality follow-back study in 2005-2006 via the nationwide Sentinel Network of General Practitioners. Standardised face-to-face interviews were conducted with GPs for all reported patients who did not die suddenly or totally unexpectedly at home, as judged by the GP.
Results We conducted 205 interviews. Of these, 27 patients had at some point expressed a wish to receive a drug administered by a physician with the explicit intention to end life, i.e. euthanasia. Thirteen of these formulated their request explicitly and repeatedly, according to their GP. Compared with patients who expressed a wish but not an explicit/repeated request for euthanasia, those patients' request was more often documented (8/13 vs. 2/14;p=0.01), and reiterated until their final days of life (6/13 vs. 0/14;p=0.02). Five patients received euthanasia. For the other 22 patients, GPs gave different reasons for not acceding to the request, often related to criteria stipulated in the Belgian law on euthanasia, and sometimes related to personal reasons.
Conclusions It is not uncommon for patients to ask their GP for euthanasia, although explicit requests remain relatively rare. Requests tend to vary widely in form and content, and far more are expressed than complied with. For many GPs the Belgian law on euthanasia serves as a guiding principle in this decision-making process, although in a minority of the cases a GP's personal opinion towards euthanasia seems to be decisive

Publication year:2011

Keywords:euthanasia, requests, end-of-life care, general practitioner