• Katja Ten Cate, Donald G van Tol, and Suzanne van de Vathorst.
• Department of General Practice, section Medical Ethics, Academic Medical Center, Amsterdam, The Netherlands.
• Fam Pract. 2017 Nov 16; 34 (6): 723-729.

BackgroundIn the Netherlands, euthanasia or assisted suicide (EAS) is neither a right of the patient nor a duty of the physician. Beside the legal requirements, physicians can weigh their own considerations when they decide on a request for EAS.ObjectiveWe aim at a better understanding of the considerations that play a role when physicians decide on a request for EAS.MethodsThis was a qualitative study. We analysed 33 interviews held with general practitioners (GPs) from various regions in the Netherlands.ResultsThe considerations found can be divided in three main types. (i) Perceived legal criteria, (ii) individual interpretations of the legal criteria and (iii) considerations unrelated to the legal criteria. Considerations of this 3rd type have not been mentioned so far in the literature and the debate on EAS. Examples are: the family should agree to EAS, the patient's attitude must reflect resignation, or conflicts must be resolved.ConclusionsOur study feeds the ethical discussion on the tension that can arise between a physician's own views on death and dying, and the views and preferences of his patients. When considerations like 'no unresolved conflicts' or 'enough resignation' influence the decision to grant a request for EAS this poses questions from an ethical and professional point of view. We hypothesise that these considerations reflect GPs' views on what 'good dying' entails and we advocate further research on this topic.© The Author 2017. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

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