Lewis, Deborah and Preston, Nancy and Grinyer, Anne (2018) What is the experience of assisted dying for Dutch healthcare staff working in a hospice or chronic disease care centre? Masters thesis, Lancaster University.
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Abstract
What is the experience of assisted dying for Dutch healthcare staff working in a hospice or chronic disease care centre? Background: Assisted dying is a contemporary issue with worldwide interest. Debate has largely focused around individuals seeking the right-to-die. Lacking thus far has been consideration of the experience of clinical staff. This research was conducted at a chronic disease centre and a hospice in the Netherlands where permissive legislation was first enacted. Aim: The aim of this research was to explore and gain a deeper understanding of the assisted dying experience of Dutch healthcare staff to inform and broaden the global debate. Methods: This study provides the first application of a constructivist qualitative inquiry with three professional groups to analyse the care experience of 21 doctors, nurses and therapists practising in the Netherlands. Data from semi-structured interviews were analysed using thematic analysis to identify latent and semantic themes from which new insight was gained. Findings: Requests for an assisted death were received and processed by all staff groups. Large numbers were heard at the hospice where fifty percent of the patients wanted to discuss it. Requests required an assessment of seriousness, an exploration of patient fears and an evaluation of psychological status. Optimum palliative care had to be ensured. Such measures were found to resolve or delay the majority of requests. Assisted deaths challenged staff and were perceived as not normal. The administration of lethal drugs and post-death case scrutiny were stressful for doctors. After death debriefing and psychological support were valued by staff, but adjustment took some time. Doctors reported a recovery period in which they were unable to respond to further requests rising equity of access issues. The involvement of nurses and therapists, including activities previously unreported, safeguarded patients. The provision of assisted dying was perceived as significantly increasing workload, but this was not resented. Support for the provision of assisted dying was overwhelming, but this was unqualified in only a third of participants.