KWALITATIEF ONDERZOEK LEVENSEINDECOUNSELING

Onderzoeker Martijn Hagens (Vrije Universiteit Amsterdam) heeft in samenwerking met Bregje D Onwuteaka-Philipsen en H Roeline W Pasman een artikel gepubliceerd in de Journal of Medical Ethics. Het artikel doet verslag van 17 diepteinterviews met clienten van de levenseindecounselors die in 2012 nog samenwerkten met Stichting de Einder.
Hieronder vindt u de Engelstalige samenvatting (met eindconclusie). Het gehele artikel is hier te vinden. 
Onderzoeksresultaat: de mogelijkheid van zelfeuthanasie wordt onderzocht en/of gekozen ofwel omdat een euthanasietraject afgewezen is of de toegang daartoe nog onzeker, ofwel omdat men eigen regie (zelfbeschikking) en onafhankelijkheid van artsen ambieert. 

ABSTRACT
Background
In the Netherlands, people can receive (limited) demedicalised assistance in suicide (DAS)—an option less well known than physician-assisted dying (PAD).
Aim
​This study explores which trajectories people take to seek DAS, through open-coding and inductive analysis of in-depth interviews with 17 people who receive(d) DAS from counsellors facilitated by foundation De Einder.
Results
People sought DAS as a result of current suffering or as a result of anticipating possible prospective suffering. People with current suffering were unable or assumed they would be unable to obtain PAD. For people anticipating possible prospective suffering, we distinguished two trajectories. In one trajectory, people preferred PAD but were not reassured of help by the physician in due time and sought DAS as a backup plan. In the other trajectory, people expressed a preference for DAS mainly as a result of emphasising selfdetermination, independence, taking their own responsibility and preparing suicide carefully. In all trajectories, dissatisfaction with physician–patient communication—for instance about (a denied request for) PAD or fearing to discuss this—influenced the decision to seek DAS.
Conclusions
While PAD is the preferred option of people in two trajectories, obtaining PAD is uncertain and not always possible. Dissatisfaction with physician– patient communication can result in the physician not being involved in DAS, being unable to diagnose diseases and offer treatment nor offer reassurance that people seem to seek. We plea for more mutual understanding, respect and empathy for the limitations and possibilities of the position of the physician and the patient in discussing assistance in dying.