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

Objective: To investigate the emotional feelings reported by physicians in the Netherlands after having performed euthanasia or other medical end-of-l ife decisions. Design: Nationwide interview study in the Netherlands, November 1995 throug h February 1996. Participants and setting: A random sample of 405 physicians (general practi tioners, nursing home physicians, and clinical specialists). Main outcome measures: Subsequent feelings of physicians about their most r ecent cases (if any) of euthanasia, assisted suicide, life-ending without a n explicit request from the patient, and alleviation of pain and other symp toms 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 repor ted in 42%, most frequently referred to as emotional (28%) or burdensome (2 5%). Feelings of discomfort were highest for euthanasia (75%; P < 0.000). 9 5% of physicians were willing to perform euthanasia or assisted suicide aga in in similar situations. Afterwards, 5% had doubts, but none had regrets, about performing euthanasia. Conclusions. Hastening the death of a patient evokes different feelings amo ng physicians. Although performing euthanasia is often experienced as burde nsome 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.