Abstract
Objective—Consultation of another physician is an important method of review of the practice of euthanasia. For the project "support and consultation in euthanasia in Amsterdam" which is aimed at professionalising consultation, a protocol for consultation was developed to support the general practitioners who were going to work as consultants and to ensure uniformity.
Participants—Ten experts (including general practitioners who were experienced in euthanasia and consultation, a psychiatrist, a social geriatrician, a professor in health law and a public prosecutor) and the general practitioners who were going to use the protocol.
Evidence—There is limited literature on consultation: discursive articles and empirical studies describing the practice of euthanasia.
Consensus—An initial draft on the basis of the literature was commented on by the experts and general practitioners in two rounds. Finally, the protocol was amended after it had been used during the training of consultants.
Conclusions—The protocol differentiates between steps that are necessary in a consultation and steps that are recommended. Guidelines about four important aspects of consultation were given: independence, expertise, tasks and judgment of the consultant. In 97% of 109 consultations in which the protocol was used the consultant considered the protocol to be useful to a greater or lesser extent. Although this protocol was developed locally, it also employs universal principles. Therefore it can be of use in the development of consultation elsewhere.
Key Words: Euthanasia • assisted suicide • consultation • quality assurance • protocol
Full Text
The Full Text of this article is available as a PDF (112.5 KB).
Selected References
These references are in PubMed. This may not be the complete list of references from this article.
- Alpers A., Lo B. Physician-assisted suicide in Oregon. A bold experiment. JAMA. 1995 Aug 9;274(6):483–487. [PubMed] [Google Scholar]
- Baile W. F., DiMaggio J. R., Schapira D. V., Janofsky J. S. The request for assistance in dying. The need for psychiatric consultation. Cancer. 1993 Nov 1;72(9):2786–2791. doi: 10.1002/1097-0142(19931101)72:9<2786::aid-cncr2820720942>3.0.co;2-2. [DOI] [PubMed] [Google Scholar]
- Emanuel E. J., Daniels E. R., Fairclough D. L., Clarridge B. R. The practice of euthanasia and physician-assisted suicide in the United States: adherence to proposed safeguards and effects on physicians. JAMA. 1998 Aug 12;280(6):507–513. doi: 10.1001/jama.280.6.507. [DOI] [PubMed] [Google Scholar]
- Emanuel L. L. Facing requests for physician-assisted suicide: toward a practical and principled clinical skill set. JAMA. 1998 Aug 19;280(7):643–647. doi: 10.1001/jama.280.7.643. [DOI] [PubMed] [Google Scholar]
- Englin I. Euthanasia--the debate continues. Aust Fam Physician. 1996 Oct;25(10):1645–1646. [PubMed] [Google Scholar]
- Huyse F. J., van Tilburg W. Euthanasia policy in The Netherlands: the role of consultation-liaison psychiatrists. Hosp Community Psychiatry. 1993 Aug;44(8):733–738. doi: 10.1176/ps.44.8.733. [DOI] [PubMed] [Google Scholar]
- Kissane D. W., Street A., Nitschke P. Seven deaths in Darwin: case studies under the Rights of the Terminally Ill Act, Northern Territory, Australia. Lancet. 1998 Oct 3;352(9134):1097–1102. doi: 10.1016/s0140-6736(98)05406-3. [DOI] [PubMed] [Google Scholar]
- Meier D. E., Emmons C. A., Wallenstein S., Quill T., Morrison R. S., Cassel C. K. A national survey of physician-assisted suicide and euthanasia in the United States. N Engl J Med. 1998 Apr 23;338(17):1193–1201. doi: 10.1056/NEJM199804233381706. [DOI] [PubMed] [Google Scholar]
- Quill T. E., Lo B., Brock D. W. Palliative options of last resort: a comparison of voluntarily stopping eating and drinking, terminal sedation, physician-assisted suicide, and voluntary active euthanasia. JAMA. 1997 Dec 17;278(23):2099–2104. doi: 10.1001/jama.278.23.2099. [DOI] [PubMed] [Google Scholar]
- van der Wal G., van der Maas P. J., Bosma J. M., Onwuteaka-Philipsen B. D., Willems D. L., Haverkate I., Kostense P. J. Evaluation of the notification procedure for physician-assisted death in the Netherlands. N Engl J Med. 1996 Nov 28;335(22):1706–1711. doi: 10.1056/NEJM199611283352228. [DOI] [PubMed] [Google Scholar]