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全科医生如何在具体案例中评估安乐死的适当照护标准?

How do general practitioners assess the criteria for due care for euthanasia in concrete cases?

作者信息

Hanssen-de Wolf Johanna E, Pasman H Roeline W, Onwuteaka-Philipsen Bregje D

机构信息

Institute for Research in Extramural Medicine, Department of Public and Occupational Health, VU University Medical Center, Van der Boechorststraat 7, 1081 BT Amsterdam, The Netherlands.

出版信息

Health Policy. 2008 Sep;87(3):316-25. doi: 10.1016/j.healthpol.2007.12.009. Epub 2008 Mar 7.

Abstract

OBJECTIVE

In the Netherlands the law states that physicians are allowed to grant a request for euthanasia or physician-assisted suicide (EAS) if specific criteria for due care are met. This study investigated which sources physicians use to determine whether three of these criteria (unbearable and hopeless suffering, and no realistic alternatives for treatment) are met.

METHODS

The data were collected for the project Support and Consultation on Euthanasia in the Netherlands. General practitioners (GPs) received a written questionnaire concerning the most recent request for EAS that they had received. Of the 3614 (60%) GPs who returned the questionnaire, 1681 described the most recent request for EAS.

RESULTS

The study shows that physicians used different types of sources, and more than one source, to determine whether the criteria were met. More sources were used when the criteria were met or when a request resulted in EAS. The determination of every criterion required a different approach, but for all criteria discussions with colleagues were important.

CONCLUSIONS

Using less sources when a criterion is not met could possibly lead to less extensive consideration of the criteria, and therefore to assessing too easily that the request does not meet the criteria for due care.

摘要

目的

在荷兰,法律规定如果满足特定的适当照护标准,医生可以批准安乐死或医生协助自杀(EAS)的请求。本研究调查了医生使用哪些来源来确定这些标准中的三项(无法忍受且绝望的痛苦,以及没有现实的治疗替代方案)是否得到满足。

方法

数据是为荷兰安乐死支持与咨询项目收集的。全科医生(GPs)收到一份关于他们最近收到的EAS请求的书面问卷。在3614名(60%)回复问卷的全科医生中,1681名描述了最近的EAS请求。

结果

研究表明,医生使用不同类型的来源,且不止一种来源,来确定标准是否得到满足。当标准得到满足或请求导致了EAS时,使用的来源更多。确定每个标准都需要不同的方法,但对于所有标准而言,与同事的讨论都很重要。

结论

当一项标准未得到满足时使用较少的来源可能会导致对标准的考虑不够全面,从而轻易评估该请求不符合适当照护标准。

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