University Medical Center Groningen, Department of Health Sciences, Section Metamedica, University of Groningen, The Netherlands.
Health Policy. 2012 May;105(2-3):296-302. doi: 10.1016/j.healthpol.2012.01.014. Epub 2012 Mar 13.
A pivotal due care criterion for lawful euthanasia in the Netherlands is that doctors must be convinced that a patient requesting for euthanasia, suffers unbearably. Our study aims to find out how doctors judge if a patient suffers unbearably. How do doctors bridge the gap from 3rd person assessment to 1st person experience? We performed a qualitative interview study among 15 physicians, mainly general practitioners, who participated earlier in a related quantitative survey on the way doctors apply the suffering criterion. Results show that doctors follow different 'cognitive routes' when assessing a patients suffering in the context of a euthanasia request. Sometimes doctors do this imagining how she herself would experience the situation of the patient ('imagine self'). Doctors may also try to adopt the perspective of the patient and imagine what the situation is like for this particular patient ('imagine other'). Besides this we found that the (outcome of the) assessment is influenced by a doctor's private norms, values and emotions considering (the performance of) euthanasia. We conclude by arguing why doctors should be aware of both the 'cognitive route' followed as well as the influence of their own personal norms on the assessment of suffering in the context of euthanasia requests.
在荷兰，合法安乐死的关键是医生必须确信请求安乐死的患者正在承受无法忍受的痛苦。我们的研究旨在了解医生如何判断患者是否正在承受无法忍受的痛苦。医生如何弥合从第三人称评估到第一人称体验的差距？我们对 15 名医生进行了定性访谈研究，这些医生主要是全科医生，他们之前曾参与过一项关于医生如何应用痛苦标准的相关定量调查。结果表明，医生在评估安乐死请求中患者的痛苦时，会遵循不同的“认知途径”。有时，医生会想象自己会如何体验患者的情况（“想象自我”）。医生也可能试图采用患者的视角，想象这个特定患者的情况（“想象他人”）。此外，我们发现，评估还受到医生在考虑（实施）安乐死时的私人规范、价值观和情感的影响。最后，我们认为医生应该意识到在安乐死请求背景下评估痛苦时所遵循的“认知途径”以及他们自己的个人规范的影响。
