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Communication on euthanasia in general practice: experiences of patients and their physicians.

Borgsteede, S.D., Riedstra, C., Deliens, L., Francke, A.L., Stalman, W.A.B., Willems, D.L., Eijk, T.T.M. van, Wal, G. van der. Communication on euthanasia in general practice: experiences of patients and their physicians. European Journal of Palliative Care: 2003, 10(4), 42
Object of the study: Euthanasia continues to be an issue of moral debate in end of life care. As the general practitioner has a central role in performing and co-ordinating en-of-life home care in the Netherlands, he is regulartly confronted with patients requesting (information on) euthanasia. The research question of this paper is: how do general practitioners and their patients experience communication on euthanasia? Method: In a qualitative research design, we interviewed 15 terminally ill patients and their 15 GPs. Data were analysed inductively and separately by the first two authors. Results: Initiative in communication on euthanasia was for GPs and their patients an important concept. GPs left the initiative of communication to the patient and in the course of their illness most patients raised this topic themselves. Direct communication on euthanasia was not always necessary, when they had exchanged views on related issues like religion. Other emerging concepts were: the support patients experience by communication about end of life decision making, accessibility of GPs and communication between GPs and other care providers. Conclusion: Discussing euthanasia seems to be a way to talk about the possibilities of palliative care as much as the first step in a medical end of life decision. This study suggests that the possibility to talk about euthanasia offers GPs and patients the opportunity to discuss problems and wishes more openly and directly GPs are carefull in raising the subject of euthanasia. (aut.ref.)