title: 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.
  
  
  METHODS
  Nationwide interview study in The Netherlands, November 1995 through February 1996.
  
  
  METHODS
  A random sample of 405 physicians (general practitioners, nursing home physicians, and clinical specialists).
  
  
  METHODS
  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.
authors.affiliation: Vrije Universiteit Medical Centre, Institute for Research in Extramural Medicine, Department of Social Medicine, Amsterdam, The Netherlands. I.Haverkate.gpnh@med.vu.nl
authors.forename: I
authors.initials: I
authors.lastname: Haverkate
authors.forename: A
authors.initials: A
authors.lastname: van der Heide
authors.forename: B D
authors.initials: BD
authors.lastname: Onwuteaka-Philipsen
authors.forename: P J
authors.initials: PJ
authors.lastname: van der Maas
authors.forename: G
authors.initials: G
authors.lastname: van der Wal
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D000368:Aged; D003657:Decision Making; D004644:Emotions; D028601:Euthanasia, Active / Q000523:psychology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009426:Netherlands; D010820:Physicians / Q000523:psychology*; D012189:Retrospective Studies; D017236:Suicide, Assisted / Q000523:psychology*