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The engagement of psychiatrists in the assessment of euthanasia requests from psychiatric patients in Belgium: a survey study
BACKGROUND: Since its legalisation in 2002, the number of times euthanasia has been carried out in response to requests from adults with psychiatric conditions (APC) has continued to increase. However, little is known about why and how psychiatrists become engaged in the assessment of such euthanasi...
Autores principales: | , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7414658/ https://www.ncbi.nlm.nih.gov/pubmed/32770966 http://dx.doi.org/10.1186/s12888-020-02792-w |
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author | Verhofstadt, Monica Audenaert, Kurt Van den Broeck, Kris Deliens, Luc Mortier, Freddy Titeca, Koen Pardon, Koen De Bacquer, Dirk Chambaere, Kenneth |
author_facet | Verhofstadt, Monica Audenaert, Kurt Van den Broeck, Kris Deliens, Luc Mortier, Freddy Titeca, Koen Pardon, Koen De Bacquer, Dirk Chambaere, Kenneth |
author_sort | Verhofstadt, Monica |
collection | PubMed |
description | BACKGROUND: Since its legalisation in 2002, the number of times euthanasia has been carried out in response to requests from adults with psychiatric conditions (APC) has continued to increase. However, little is known about why and how psychiatrists become engaged in the assessment of such euthanasia requests. METHODS: A cross-sectional survey study was conducted between November 2018 and April 2019 of 499 psychiatrists affiliated with the Flemish Psychiatry Association. Chi square/Fisher’s exact tests were performed to examine if, and to what extent, psychiatrists’ backgrounds relate to their concrete experiences. The answers to the open question regarding motives for (non-) engagement were thematically coded. RESULTS: Two hundred one psychiatrists participated, a response rate of 40%. During their careers, 80% of those responding have been confronted with at least one euthanasia request from an APC patient and 73% have become involved in the assessment procedure. Their engagement was limited to the roles of: referring physician (in 44% of the psychiatrists), attending physician (30%), legally required ‘advising physician’ (22%), and physician participating in the actual administration of the lethal drugs (5%). Within the most recent 12 months of practice, 61% of the respondents have been actively engaged in a euthanasia assessment procedure and 9% have refused at least once to be actively engaged due to their own conscientious objections and/or the complexity of the assessment. The main motive for psychiatrists to engage in euthanasia is the patient’s fundamental right in Belgian law to ask for euthanasia and the psychiatrist’s duty to respect that. The perception that they were sufficiently competent to engage in a euthanasia procedure was greater in psychiatrists who have already had concrete experience in the procedure. CONCLUSIONS: Although the majority of psychiatrists have been confronted with euthanasia requests from their APC patients, their engagement is often limited to referring the request to a colleague physician for further assessment. More research is needed to identify the determinants of a psychiatrist’s engagement in euthanasia for their APC patients and to discover the consequences of their non-, or their restricted or full engagement, on both the psychotherapeutic relationship and the course of the euthanasia request. |
format | Online Article Text |
id | pubmed-7414658 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-74146582020-08-10 The engagement of psychiatrists in the assessment of euthanasia requests from psychiatric patients in Belgium: a survey study Verhofstadt, Monica Audenaert, Kurt Van den Broeck, Kris Deliens, Luc Mortier, Freddy Titeca, Koen Pardon, Koen De Bacquer, Dirk Chambaere, Kenneth BMC Psychiatry Research Article BACKGROUND: Since its legalisation in 2002, the number of times euthanasia has been carried out in response to requests from adults with psychiatric conditions (APC) has continued to increase. However, little is known about why and how psychiatrists become engaged in the assessment of such euthanasia requests. METHODS: A cross-sectional survey study was conducted between November 2018 and April 2019 of 499 psychiatrists affiliated with the Flemish Psychiatry Association. Chi square/Fisher’s exact tests were performed to examine if, and to what extent, psychiatrists’ backgrounds relate to their concrete experiences. The answers to the open question regarding motives for (non-) engagement were thematically coded. RESULTS: Two hundred one psychiatrists participated, a response rate of 40%. During their careers, 80% of those responding have been confronted with at least one euthanasia request from an APC patient and 73% have become involved in the assessment procedure. Their engagement was limited to the roles of: referring physician (in 44% of the psychiatrists), attending physician (30%), legally required ‘advising physician’ (22%), and physician participating in the actual administration of the lethal drugs (5%). Within the most recent 12 months of practice, 61% of the respondents have been actively engaged in a euthanasia assessment procedure and 9% have refused at least once to be actively engaged due to their own conscientious objections and/or the complexity of the assessment. The main motive for psychiatrists to engage in euthanasia is the patient’s fundamental right in Belgian law to ask for euthanasia and the psychiatrist’s duty to respect that. The perception that they were sufficiently competent to engage in a euthanasia procedure was greater in psychiatrists who have already had concrete experience in the procedure. CONCLUSIONS: Although the majority of psychiatrists have been confronted with euthanasia requests from their APC patients, their engagement is often limited to referring the request to a colleague physician for further assessment. More research is needed to identify the determinants of a psychiatrist’s engagement in euthanasia for their APC patients and to discover the consequences of their non-, or their restricted or full engagement, on both the psychotherapeutic relationship and the course of the euthanasia request. BioMed Central 2020-08-08 /pmc/articles/PMC7414658/ /pubmed/32770966 http://dx.doi.org/10.1186/s12888-020-02792-w Text en © The Author(s) 2020 Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data. |
spellingShingle | Research Article Verhofstadt, Monica Audenaert, Kurt Van den Broeck, Kris Deliens, Luc Mortier, Freddy Titeca, Koen Pardon, Koen De Bacquer, Dirk Chambaere, Kenneth The engagement of psychiatrists in the assessment of euthanasia requests from psychiatric patients in Belgium: a survey study |
title | The engagement of psychiatrists in the assessment of euthanasia requests from psychiatric patients in Belgium: a survey study |
title_full | The engagement of psychiatrists in the assessment of euthanasia requests from psychiatric patients in Belgium: a survey study |
title_fullStr | The engagement of psychiatrists in the assessment of euthanasia requests from psychiatric patients in Belgium: a survey study |
title_full_unstemmed | The engagement of psychiatrists in the assessment of euthanasia requests from psychiatric patients in Belgium: a survey study |
title_short | The engagement of psychiatrists in the assessment of euthanasia requests from psychiatric patients in Belgium: a survey study |
title_sort | engagement of psychiatrists in the assessment of euthanasia requests from psychiatric patients in belgium: a survey study |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7414658/ https://www.ncbi.nlm.nih.gov/pubmed/32770966 http://dx.doi.org/10.1186/s12888-020-02792-w |
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