The Role of Family in Euthanasia Decision Making

Kimsma, Gerrit K.; Leeuwen, Evert van

doi:10.1007/s10730-007-9048-z

Cited by 20 publications

(12 citation statements)

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“…Family members’ and HCPs’ experiences and involvement vary, depending on jurisdiction and the stage of the assisted dying process. 7,8 In most jurisdictions, the stages include: the initial request to HCPs and disclosure of request to family members (if the person chooses to do so); prescribed assessment strategies to determine eligibility; a reflective waiting period between eligibility and the scheduled date of death, which allows patients to reconsider their choice; the provision of the lethal medication; and the period following death. 1,8 Those closely involved in peoples’ journeys with assisted dying are instrumental in decision making and to the process.…”

Section: Experiences Of Family Members and Healthcare Providersmentioning

confidence: 99%

Relational influences on experiences with assisted dying: A scoping review

et al. 2020

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Background: Family members and healthcare providers play an integral role in a person’s assisted dying journey. Their own needs during the assisted dying journey are often, however, unrecognized and underrepresented in policies and guidelines. Circumstances under which people choose assisted dying, and relational contexts such as the sociopolitical environment, may influence the experiences of family members and healthcare providers. Ethical considerations: Ethics approval was not required to conduct this review. Aim: This scoping review aims to identify the relational influences on the experiences of family members and healthcare providers of adults who underwent assisted dying and of those unable to access assisted dying due to the loss of capacity to consent. Methods: A literature search was conducted in four databases, including MEDLINE, EMBASE, Cumulative Index to Nursing and Allied Health Literature (CINAHL) and PsycINFO. The search retrieved 12,074 articles, a number narrowed down to 172 articles for full-text screening. Thirty-six articles met the established inclusion criteria. A feminist relational framework guided the data analysis. Results: Five key themes on the influences of family members’ and healthcare providers’ experiences throughout the assisted dying process were synthesized from the data. They include (1) relationships as central to beginning the process, (2) social and political influences on decision making, (3) complex roles and responsibilities of family members and healthcare providers, (4) a unique experience of death, and (5) varying experiences following death. Conclusion: The feminist relational lens, used to guide analysis, shed light on the effect of the sociopolitical influences and the relationships among patients, families, and healthcare providers on each other’s experiences. Addressing the needs of the family members and healthcare providers is vital to improving the assisted dying process. Including families’ and healthcare providers’ needs within institutional policies and enhancing collaboration and communication among those involved could improve the overall experience.

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Section: Experiences Of Family Members and Healthcare Providersmentioning

confidence: 99%

Relational influences on experiences with assisted dying: A scoping review

et al. 2020

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“…The family’s role in the Dutch practice of euthanasia and assisted suicide has been receiving critical attention lately, although their involvement had already been documented before and shortly after the enactment of the euthanasia law [ 9 , 10 ]. Recent qualitative studies describe how family members such as partners and children can influence the process of euthanasia decision-making and how some physicians take family members’ well-being and bereavement into account when deciding whether or not to grant a request [ 11 , 12 ].…”

Section: Introductionmentioning

confidence: 99%

“…To date, a systematic review of empirical research addressing the involvement of family members in the Dutch practice of EAS has not been performed. Several authors have described different aspects of family involvement, such as the different roles family members may take in euthanasia decision-making [ 10 ], the bereavement process of relatives after EAS [ 14 , 16 ] and the potential influence of family members’ suffering on end-of-life decision-making [ 15 ]. However, there is no comprehensive overview that incorporates all elements that might be relevant for the Dutch practice of EAS.…”

Section: Introductionmentioning

confidence: 99%

The involvement of family in the Dutch practice of euthanasia and physician assisted suicide: a systematic mixed studies review

2019

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Background Family members do not have an official position in the practice of euthanasia and physician assisted suicide (EAS) in the Netherlands according to statutory regulations and related guidelines. However, recent empirical findings on the influence of family members on EAS decision-making raise practical and ethical questions. Therefore, the aim of this review is to explore how family members are involved in the Dutch practice of EAS according to empirical research, and to map out themes that could serve as a starting point for further empirical and ethical inquiry. Methods A systematic mixed studies review was performed. The databases Pubmed, Embase, PsycInfo, and Emcare were searched to identify empirical studies describing any aspect of the involvement of family members before, during and after EAS in the Netherlands from 1980 till 2018. Thematic analysis was chosen as method to synthesize the quantitative and qualitative studies. Results Sixty-six studies were identified. Only 14 studies had family members themselves as study participants. Four themes emerged from the thematic analysis. 1) Family-related reasons (not) to request EAS. 2) Roles and responsibilities of family members during EAS decision-making and performance. 3) Families’ experiences and grief after EAS. 4) Family and ‘the good euthanasia death’ according to Dutch physicians. Conclusion Family members seem to be active participants in EAS decision-making, which goes hand in hand with ambivalent feelings and experiences. Considerations about family members and the social context appear to be very important for patients and physicians when they request or grant a request for EAS. Although further empirical research is needed to assess the depth and generalizability of the results, this review provides a new perspective on EAS decision-making and challenges the Dutch ethical-legal framework of EAS. Euthanasia decision-making is typically framed in the patient-physician dyad, while a patient-physician-family triad seems more appropriate to describe what happens in clinical practice. This perspective raises questions about the interpretation of autonomy, the origins of suffering underlying requests for EAS, and the responsibilities of physicians during EAS decision-making.

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“…Research in this field has focused on various aspects, such as the moral and ethical aspects (Bélanger et al, 2019; Kouwenhoven, van Thiel, van der Heide, Rietjens, https://econtent.hogrefe.com/doi/pdf/10.1027/0227-5910/a000630 - Karl Andriessen <karl.andriessen@gmail.com> -Monday, October 28, 20191:23:46 PM -IP Address:128.250.0.121 & van Delden, 2019Mishara & Weisstub, 2013;Speijer & Diekstra, 1980), public acceptance (Cohen et al, 2006;Frey & Hans, 2016;Marcoux, Mishara, & Durand, 2007;Poma et al, 2015), and the legal status and epidemiology of euthanasia and PAS (Cohen, Dierickx, Penders, Deliens, & Chambaere, 2018;Steck, Egger, Maessen, Reisch, & Zwahlen, 2013). Studies have also looked at the views of individuals requesting medical assistance in dying (Dees, Vernooij-Dassen, Dekkers, Vissers, & Van Weel, 2011;Hendry et al, 2013;Lapierre et al, 2018), family involvement in end-of-life decision-making (Gamondi, 2017;Gamondi, Pott, Preston, & Payne, 2018;Kimsma & Van Leeuwen, 2007;Pott, Dubois, Currat, & Gamondi, 2011), and the perceptions of physicians (Emanuel et al, 2016;Ganzini, Dobscha, Heintz, & Press, 2003) and other professional caregivers (Castelli Dransart, Scozzari, & Voélin, 2017).…”

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confidence: 99%

Grief After Euthanasia and Physician-Assisted Suicide

Andriessen

Krysińska

Dransart

et al. 2020

Crisis

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Abstract. Background: Several countries have regulated euthanasia and physician-assisted suicide (PAS). Research has looked at the experiences of patients, family, and professionals. However, little is known of the effects on bereaved individuals. Aims: We aimed to assess (a) what is known about the grief and mental health of people bereaved by euthanasia or PAS and (b) the quality of the research. Method: Systematic review according to PRISMA guidelines with searches in Cinahl, Embase, PsycINFO, Pubmed, and Scopus. Results: The searches identified 10 articles (eight studies), and the study quality was fair. People bereaved by euthanasia/PAS generally had similar or lower scores on measures of disordered grief, mental health, and posttraumatic stress compared with those who died naturally. Lack of social support and secrecy may compound their grief. Being involved in the decision-making process and having the feeling of honoring the deceased's will may facilitate their grief. Limitations: Studies used self-reports from non-random self-selected participants, were retrospective, and were conducted in only three countries. Conclusion: There is little evidence of increased risk of adverse grief or mental health outcomes in people bereaved by euthanasia/PAS. As more countries legalize assisted dying, high-quality studies of the factors that may hinder or facilitate the grief process are needed.

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The Role of Family in Euthanasia Decision Making

Cited by 20 publications

References 5 publications

Relational influences on experiences with assisted dying: A scoping review

Relational influences on experiences with assisted dying: A scoping review

The involvement of family in the Dutch practice of euthanasia and physician assisted suicide: a systematic mixed studies review

Grief After Euthanasia and Physician-Assisted Suicide

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