Ettema E, Gijsbers van Wijk C, Hulst S, Widdershoven G
Tijdschr Psychiatr. 2019;61(1):32-40.
In the Netherlands, increasing attention is being paid to psychiatric patients with a request for termination of life. One discussion related to this is the role of the family. However, the experiences and wishes of the family regarding their involvement in dealing with a psychiatric patient's request for termination of life, are not yet well documented.
AIM: To investigate the experiences and wishes of families regarding their role in dealing with the psychiatric patient's request for termination of life, and to develop a checklist for physicians to adequately involve the family in the process of dealing with such a request.
METHOD: The experiences and wishes of families regarding their role in dealing with a psychiatric patient's request for termination of life were investigated in a focus group meeting with family members. Based on the results, recommendations were formulated for physicians and their feasibility was tested in a dialogue group of family members and caregivers. Finally, the results were discussed in a focus group of family members to develop a checklist for physicians to involve the family in dealing with a psychiatric patient's request for termination of life.
RESULTS: Family members prefer that physicians: 1. involve the family in the process and understand the impact of the situation on family members; 2. discuss expectations and explore the wishes of the family; 3. make use of the knowledge and expertise of the family in order to understand the patient in the context of his/her life; 4. support the family and provide after care, and jointly evaluate the process. The recommendations were consolidated in a checklist for physicians about involving the family in dealing with a psychiatric patient's request for termination of life.
CONCLUSION: It is expected that application of the recommendations and the checklist will promote adequate involvement of the family in dealing with a psychiatric patient's request for termination of life.
在荷兰，对于请求终止生命的精神病患者的关注日益增加。与此相关的一个讨论是家庭的作用。然而，关于家庭在处理精神病患者终止生命请求方面的经历和意愿，目前尚无充分记录。
调查家庭在处理精神病患者终止生命请求中所扮演角色的经历和意愿，并为医生制定一份清单，以便在处理此类请求的过程中充分让家庭参与进来。
通过与家庭成员进行焦点小组会议，调查家庭在处理精神病患者终止生命请求中所扮演角色的经历和意愿。根据结果为医生制定建议，并在家庭成员和护理人员对话小组中测试其可行性。最后，在家庭成员焦点小组中讨论结果，以制定一份让家庭参与处理精神病患者终止生命请求的医生清单。
家庭成员希望医生：1. 在过程中让家庭参与并了解情况对家庭成员的影响；2. 讨论期望并探究家庭的意愿；3. 利用家庭的知识和专长以在患者生活背景下理解患者；4. 支持家庭并提供后续护理，并共同评估过程。这些建议被整合到一份关于让家庭参与处理精神病患者终止生命请求的医生清单中。
预计这些建议和清单的应用将促进家庭在处理精神病患者终止生命请求时的充分参与。
