The emotional impact on physicians of hastening the death of a patient.

Abstract

OBJECTIVE: To investigate the emotional feelings reported by physicians in The Netherlands after having performed euthanasia or other medical end-of-life decisions. DESIGN: Nationwide interview study in The Netherlands, November 1995 through February 1996. PARTICIPANTS AND SETTING: A random sample of 405 physicians (general practitioners, nursing home physicians, and clinical specialists). MAIN OUTCOME MEASURES: Subsequent feelings of physicians about their most recent cases (if any) of euthanasia, assisted suicide, life-ending without an explicit request from the patient, and alleviation of pain and other symptoms with high doses of opioids. RESULTS: The response rate was 89%. In 52% of all cases of hastening death, physicians had feelings of comfort afterwards, which included feelings of satisfaction in 44% and of relief in 13%. Feelings of discomfort were reported in 42%, most frequently referred to as emotional (28%) or burdensome (25%). Feelings of discomfort were highest for euthanasia (75%; P<0.000). 95% of physicians were willing to perform euthanasia or assisted suicide again in similar situations. Afterwards, 5% had doubts, but none had regrets, about performing euthanasia. CONCLUSIONS: Hastening the death of a patient evokes different feelings among physicians. Although performing euthanasia is often experienced as burdensome and emotional, granting the ultimate wish of a competent patient may also give physicians a feeling of having contributed to the quality of the dying process.