EMGO Institute for Health and Care Research, Department of Public and Occupational Health, VU University Medical Center, Amsterdam, The Netherlands.
Patient Educ Couns. 2013 Sep;92(3):313-8. doi: 10.1016/j.pec.2013.06.007. Epub 2013 Jul 2.
Obtaining in-depth information from both patient and physician perspectives about what happens after a request for euthanasia or physician-assisted suicide (EAS) is refused.
In-depth interviews with nine patients whose EAS request was refused and seven physicians of these patients, and with three relatives of patients who had died after a request was refused and four physicians of these patients. Interviews were conducted at least 6 months after the refusal.
A wish to die remained in all patients after refusal, although it sometimes diminished. In most cases patient and physician stopped discussing this wish, and none of the physicians had discussed plans for the future with the patient or evaluated the patient's situation after their refusal. Physicians were aware of patients' continued wish to die.
Patients who are refused EAS may subsequently be silent about a wish to die without abandoning it. Open communication about wishes to die is important, even outside the context of EAS, because if people feel unable to talk about them, their quality of life may be further diminished.
Follow up appointments after refusal could give patients the opportunity to discuss their feelings and physicians to support them.
从患者和医生的角度深入了解在拒绝安乐死或医师协助自杀（EAS）请求后会发生什么。
对 9 名 EAS 请求被拒绝的患者和他们的 7 名医生，以及 3 名请求被拒绝后死亡的患者的亲属和他们的 4 名医生进行了深入访谈。访谈是在拒绝后至少 6 个月进行的。
尽管有时会减弱，但所有患者在被拒绝后仍然希望死亡。在大多数情况下，患者和医生停止讨论这个愿望，而且没有医生与患者讨论过未来的计划，也没有评估过患者在被拒绝后的情况。医生了解患者持续的死亡愿望。
被拒绝 EAS 的患者可能会对死亡的愿望保持沉默而不放弃它。即使在 EAS 之外，公开讨论死亡的愿望也很重要，因为如果人们觉得无法谈论这些愿望，他们的生活质量可能会进一步下降。
拒绝后进行随访预约可以让患者有机会讨论自己的感受，让医生为他们提供支持。
