The involvement of family in the Dutch practice of euthanasia and physician assisted suicide: a systematic mixed studies review
Abstract Background Family members do not have an official position in the practice of euthanasia and physician assisted suicide (EAS) in the Netherlands according to statutory regulations and related guidelines. However, recent empirical findings on the influence of family members on EAS decision-m...
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| Format: | Article |
| Language: | English |
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BMC
2019-04-01
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| Series: | BMC Medical Ethics |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s12910-019-0361-2 |
| _version_ | 1818283227875377152 |
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| author | Bernadette Roest Margo Trappenburg Carlo Leget |
| author_facet | Bernadette Roest Margo Trappenburg Carlo Leget |
| author_sort | Bernadette Roest |
| collection | DOAJ |
| description | Abstract Background Family members do not have an official position in the practice of euthanasia and physician assisted suicide (EAS) in the Netherlands according to statutory regulations and related guidelines. However, recent empirical findings on the influence of family members on EAS decision-making raise practical and ethical questions. Therefore, the aim of this review is to explore how family members are involved in the Dutch practice of EAS according to empirical research, and to map out themes that could serve as a starting point for further empirical and ethical inquiry. Methods A systematic mixed studies review was performed. The databases Pubmed, Embase, PsycInfo, and Emcare were searched to identify empirical studies describing any aspect of the involvement of family members before, during and after EAS in the Netherlands from 1980 till 2018. Thematic analysis was chosen as method to synthesize the quantitative and qualitative studies. Results Sixty-six studies were identified. Only 14 studies had family members themselves as study participants. Four themes emerged from the thematic analysis. 1) Family-related reasons (not) to request EAS. 2) Roles and responsibilities of family members during EAS decision-making and performance. 3) Families’ experiences and grief after EAS. 4) Family and ‘the good euthanasia death’ according to Dutch physicians. Conclusion Family members seem to be active participants in EAS decision-making, which goes hand in hand with ambivalent feelings and experiences. Considerations about family members and the social context appear to be very important for patients and physicians when they request or grant a request for EAS. Although further empirical research is needed to assess the depth and generalizability of the results, this review provides a new perspective on EAS decision-making and challenges the Dutch ethical-legal framework of EAS. Euthanasia decision-making is typically framed in the patient-physician dyad, while a patient-physician-family triad seems more appropriate to describe what happens in clinical practice. This perspective raises questions about the interpretation of autonomy, the origins of suffering underlying requests for EAS, and the responsibilities of physicians during EAS decision-making. |
| first_indexed | 2024-12-13T00:33:34Z |
| format | Article |
| id | doaj.art-c37eb4d8675d4418bc78a7a0e61dc560 |
| institution | Directory Open Access Journal |
| issn | 1472-6939 |
| language | English |
| last_indexed | 2024-12-13T00:33:34Z |
| publishDate | 2019-04-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Medical Ethics |
| spelling | doaj.art-c37eb4d8675d4418bc78a7a0e61dc5602022-12-22T00:05:15ZengBMCBMC Medical Ethics1472-69392019-04-0120112110.1186/s12910-019-0361-2The involvement of family in the Dutch practice of euthanasia and physician assisted suicide: a systematic mixed studies reviewBernadette Roest0Margo Trappenburg1Carlo Leget2University of Humanistic StudiesUniversity of Humanistic StudiesUniversity of Humanistic StudiesAbstract Background Family members do not have an official position in the practice of euthanasia and physician assisted suicide (EAS) in the Netherlands according to statutory regulations and related guidelines. However, recent empirical findings on the influence of family members on EAS decision-making raise practical and ethical questions. Therefore, the aim of this review is to explore how family members are involved in the Dutch practice of EAS according to empirical research, and to map out themes that could serve as a starting point for further empirical and ethical inquiry. Methods A systematic mixed studies review was performed. The databases Pubmed, Embase, PsycInfo, and Emcare were searched to identify empirical studies describing any aspect of the involvement of family members before, during and after EAS in the Netherlands from 1980 till 2018. Thematic analysis was chosen as method to synthesize the quantitative and qualitative studies. Results Sixty-six studies were identified. Only 14 studies had family members themselves as study participants. Four themes emerged from the thematic analysis. 1) Family-related reasons (not) to request EAS. 2) Roles and responsibilities of family members during EAS decision-making and performance. 3) Families’ experiences and grief after EAS. 4) Family and ‘the good euthanasia death’ according to Dutch physicians. Conclusion Family members seem to be active participants in EAS decision-making, which goes hand in hand with ambivalent feelings and experiences. Considerations about family members and the social context appear to be very important for patients and physicians when they request or grant a request for EAS. Although further empirical research is needed to assess the depth and generalizability of the results, this review provides a new perspective on EAS decision-making and challenges the Dutch ethical-legal framework of EAS. Euthanasia decision-making is typically framed in the patient-physician dyad, while a patient-physician-family triad seems more appropriate to describe what happens in clinical practice. This perspective raises questions about the interpretation of autonomy, the origins of suffering underlying requests for EAS, and the responsibilities of physicians during EAS decision-making.http://link.springer.com/article/10.1186/s12910-019-0361-2Physician-assisted dyingEuthanasiaFamilyEnd-of-lifeDecision-making |
| spellingShingle | Bernadette Roest Margo Trappenburg Carlo Leget The involvement of family in the Dutch practice of euthanasia and physician assisted suicide: a systematic mixed studies review BMC Medical Ethics Physician-assisted dying Euthanasia Family End-of-life Decision-making |
| title | The involvement of family in the Dutch practice of euthanasia and physician assisted suicide: a systematic mixed studies review |
| title_full | The involvement of family in the Dutch practice of euthanasia and physician assisted suicide: a systematic mixed studies review |
| title_fullStr | The involvement of family in the Dutch practice of euthanasia and physician assisted suicide: a systematic mixed studies review |
| title_full_unstemmed | The involvement of family in the Dutch practice of euthanasia and physician assisted suicide: a systematic mixed studies review |
| title_short | The involvement of family in the Dutch practice of euthanasia and physician assisted suicide: a systematic mixed studies review |
| title_sort | involvement of family in the dutch practice of euthanasia and physician assisted suicide a systematic mixed studies review |
| topic | Physician-assisted dying Euthanasia Family End-of-life Decision-making |
| url | http://link.springer.com/article/10.1186/s12910-019-0361-2 |
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