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安乐死对荷兰初级保健医生的影响。

Impact of euthanasia on primary care physicians in the Netherlands.

作者信息

van Marwijk Harm, Haverkate Ilinka, van Royen Paul, The Anne-Mei

机构信息

Department of General Practice, EMGO Institute, VU University Medical Centre, BT Amsterdam, The Netherlands.

出版信息

Palliat Med. 2007 Oct;21(7):609-14. doi: 10.1177/0269216307082475.

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.

摘要

背景

关于在荷兰实施安乐死对基层医疗医生(PCP)产生的情感影响,人们了解有限。

目的

更深入了解实施安乐死或协助自杀对基层医疗医生的情感影响,并据此调整全科医生实习培训的教育需求。

方法

定性研究,包括四项焦点小组研究。研究背景为荷兰的基层医疗;22名基层医疗医生参与,分为四组(年长男性、年长女性、年轻男性以及一组对安乐死感兴趣的医生)。

结果

区分出不同情感的各个阶段:事件发生前(紧张)、事件进行中(失落)和事件发生后(解脱)。尽管安乐死极为罕见,但对基层医疗医生有重大影响。他们与患者的关系、孤独感、家庭的作用以及来自社会的压力是出现的主要问题。为基层医疗医生提供足够的情感空间和时间以便充分与患者告别很重要。

结论

许多基层医疗医生强调,年轻医生应在职业生涯早期就对安乐死及其他临终决策形成自己的看法。我们建议将这些问题正式纳入全科医生职业培训项目。

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