title: Communication about euthanasia in general practice: opinions and experiences of patients and their general practitioners.
abstract: OBJECTIVE
  Public opinion and professional organisations dominate the euthanasia debate, and there is a need to understand the opinions of people confronted with euthanasia. The aim of this study was to investigate whether patients and their GPs talk about euthanasia, and if so, how they communicate about this.
  
  
  METHODS
  Qualitative, semi-structured interviews were held with 20 GPs and 30 of their patients in primary care in the Netherlands, where euthanasia is legalised. The patients had a life expectancy of less than 6 months, and cancer, heart failure or chronic obstructive pulmonary disease as underlying disease.
  
  
  RESULTS
  Many patients did not communicate about euthanasia with their GP. Neither the patient nor the GP were clear in formulating their expectations concerning future decision making.
  
  
  CONCLUSIONS
  The initial patient-GP communication consisted of an exchange of opinions about situations in which euthanasia would be desirable. GPs had different opinions about who should initiate communication, and found it difficult to judge the right moment to talk.
  
  
  CONCLUSIONS
  It is essential to pay attention to education in communication about dying and euthanasia and to train the GPs to gain insight in the patient's end-of-life preferences, and to direct care at the best possible quality of life.
authors.affiliation: VU University Medical Center, Department of Public and Occupational Health, EMGO Institute, Amsterdam, The Netherlands. s.borgsteede@vumc.nl
authors.forename: Sander D
authors.initials: SD
authors.lastname: Borgsteede
authors.forename: Luc
authors.initials: L
authors.lastname: Deliens
authors.forename: Corrie
authors.initials: C
authors.lastname: Graafland-Riedstra
authors.forename: Anneke L
authors.initials: AL
authors.lastname: Francke
authors.forename: Gerrit
authors.initials: G
authors.lastname: van der Wal
authors.forename: Dick L
authors.initials: DL
authors.lastname: Willems
mesh_terms: D032722:Advance Care Planning / Q000458:organization & administration; D000368:Aged; D000369:Aged, 80 and over; D001291:Attitude of Health Personnel; D001294:Attitude to Health; D002983:Clinical Competence / Q000592:standards; D003142:Communication; D004503:Education, Medical, Graduate; D005065:Euthanasia / Q000331:legislation & jurisprudence / Q000523:psychology*; D005194:Family Practice / Q000193:education / Q000458:organization & administration; D005260:Female; D006801:Humans; D008017:Life Expectancy; D008297:Male; D008875:Middle Aged; D009426:Netherlands; D010353:Patient Education as Topic / Q000458:organization & administration; D010817:Physician-Patient Relations; D010821:Physicians, Family / Q000193:education / Q000523:psychology*; D011320:Primary Health Care / Q000458:organization & administration; D036301:Qualitative Research; D011795:Surveys and Questionnaires; D013727:Terminal Care / Q000458:organization & administration / Q000523:psychology; D019452:Terminally Ill / Q000523:psychology; D013997:Time Factors