title: Impact of euthanasia on primary care physicians in the Netherlands.
abstract: BACKGROUND
  There is only limited knowledge about the emotional impact that performing euthanasia has on primary care physicians (PCPs) in the Netherlands.
  
  
  OBJECTIVE
  To obtain more insight into the emotional impact on PCPs of performing euthanasia or assisted suicide, and to tailor the educational needs of vocational PCP trainees accordingly.
  
  
  METHODS
  Qualitative research, consisting of four focus group studies. The setting was primary care in the Netherlands; 22 PCPs participated, in four groups (older males, older females, younger males and a group with interest with regard to euthanasia).
  
  
  RESULTS
  Various phases with different emotions were distinguished: before (tension), during (loss) and after (relief) the event. Although it is a very rare occurrence, euthanasia has a major impact on PCPs. Their relationship with the patient, their loneliness, the role of the family, and pressure from society are the main issues that emerged. Making sufficient emotional space and time available to take leave adequately from a patient is important for PCPs.
  
  
  CONCLUSIONS
  Many PCPs stressed that young physicians should form their own opinions about euthanasia and other end-of-life decisions early on in their career. We recommend that these issues are officially included in the vocational training programme for general practice.
authors.affiliation: Department of General Practice, EMGO Institute, VU University Medical Centre, BT Amsterdam, The Netherlands. hwj.vanmarwijk@vumc.nl
authors.forename: Harm
authors.initials: H
authors.lastname: van Marwijk
authors.forename: Ilinka
authors.initials: I
authors.lastname: Haverkate
authors.forename: Paul
authors.initials: P
authors.lastname: van Royen
authors.forename: Anne-Mei
authors.initials: AM
authors.lastname: The
mesh_terms: D000223:Adaptation, Psychological; D001291:Attitude of Health Personnel; D003657:Decision Making; D004644:Emotions; D028601:Euthanasia, Active / Q000523:psychology*; D005260:Female; D006801:Humans; D008297:Male; D009426:Netherlands; D010819:Physician's Role / Q000523:psychology*; D011320:Primary Health Care; D011369:Professional-Patient Relations; D036301:Qualitative Research