title: Dealing with requests for euthanasia: interview study among general practitioners in Belgium.
abstract: BACKGROUND
  In many countries, physicians are confronted with requests for euthanasia. Notwithstanding that euthanasia is legally permitted in Belgium, it remains the subject of intense debate.
  
  
  OBJECTIVE
  To gather in-depth empirical data on how general practitioners (GPs) deal with these requests in Belgium.
  
  
  METHODS
  Mortality follow-back study in 2005-2006 via the nationwide Sentinel Network of General Practitioners. Standardized face-to-face interviews were conducted with GPs for all the reported patients who did not die suddenly or totally unexpectedly at home, as judged by the GP.
  
  
  RESULTS
  We conducted 205 interviews. Of these, 27 patients had at some point expressed a wish to receive a drug administered by a physician with the explicit intention to end life, that is, euthanasia. Thirteen of these formulated their requests explicitly and repeatedly, according to their GP. Compared with patients who expressed a wish but not an explicit/repeated request for euthanasia, those patients' requests were more often documented (8 of 13 vs. 2 of 14; P=0.01), and reiterated until their final days of life (6 of 13 vs. 0 of 14; P=0.02). Five patients received euthanasia. For the other 22 patients, GPs gave different reasons for not acceding to the request, often related to criteria stipulated in the Belgian law on euthanasia, and sometimes related to personal reasons.
  
  
  CONCLUSIONS
  It is not uncommon for patients to ask their GP for euthanasia, although explicit requests remain relatively rare. Requests tend to vary widely in form and content, and far more are expressed than complied with. For many GPs, the Belgian law on euthanasia serves as a guiding principle in this decision-making process, although in a minority of the cases, a GP's personal opinion toward euthanasia seems to be decisive.
authors.affiliation: End-of-Life Care Research Group, Vrije Universiteit Brussel, Brussels, Belgium. koen.meeussen@vub.ac.be
authors.forename: Koen
authors.initials: K
authors.lastname: Meeussen
authors.forename: Lieve
authors.initials: L
authors.lastname: Van den Block
authors.forename: Nathalie
authors.initials: N
authors.lastname: Bossuyt
authors.forename: Michael
authors.initials: M
authors.lastname: Echteld
authors.forename: Johan
authors.initials: J
authors.lastname: Bilsen
authors.forename: Luc
authors.initials: L
authors.lastname: Deliens
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001530:Belgium / Q000453:epidemiology; D016638:Critical Illness / Q000401:mortality*; D005065:Euthanasia / Q000706:statistics & numerical data*; D005260:Female; D058005:General Practitioners / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008875:Middle Aged; D057240:Patient Preference / Q000706:statistics & numerical data*; D010819:Physician's Role; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D012297:Right to Die; D055815:Young Adult