Medical assistance in dying law: a qualitative study of French cancer physicians

Author:

Chastenet MathildeORCID,Renard Olivier,Laurain Pierre-Antoine,Bonnot Myriam,Chvetzoff GisèleORCID

Abstract

ObjectivesThe legal landscape surrounding end-of-life care in France is subject to frequent changes. A proposed law to legalise euthanasia in April 2021 has raised questions about the role of physicians. If enacted, oncologists would likely be among the first professionals impacted, as data from countries with legalised euthanasia reveal that patients with cancer constitute the majority of those seeking this option. Currently, little is known about the attitudes of French oncologists towards euthanasia. Therefore, the aim of this study was to explore the position of cancer physicians on euthanasia and their experiences in dealing with patients who request it.MethodsWe conducted individual interviews with 24 cancer specialists (oncologists, radiotherapists and haematologists) at the Centre Léon Bérard in Lyon between August and October 2021. After full transcription, data were analysed thematically and for content. Data triangulation was used to establish the truthworthiness of the findings by two external researchers.ResultsMost cancer specialists in our study were opposed to legalising euthanasia, citing concerns about the societal, medical and ethical implications of the practice. They refused physician-assisted suicide based on their ethical duty to preserve life, avoid harm and uphold the Hippocratic Oath. Patient requests for euthanasia were rare. Surprisingly, over a quarter of the physicians interviewed did not rule out receiving active assistance in dying themselves in cases of unbearable or hopeless situations.ConclusionsThis study highlights the complex and diverse attitudes of cancer physicians towards euthanasia and physician-assisted suicide, reflecting the challenges of integrating individual and collective perspectives on end-of-life issues.

Publisher

BMJ

Subject

Medical–Surgical Nursing,Oncology (nursing),General Medicine,Medicine (miscellaneous)

Reference15 articles.

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2. Comité Consultatif national D’Éthique . Avis 139 questions Éthiques relatives aux situations de fin de vie: autonomie et solidarité. Available: https://www.ccne-ethique.fr/node/529

3. Economos G , Moulin P , Perceau-Chambard É , et al . Société française d’accompagnement et de soins palliatifs (SFAP). legalised active assistance in dying: palliative care stakeholders' national e-consultation. BMJ Support Palliat Care 2023;13. doi:10.1136/spcare-2022-004081

4. Le Quotidien du Médecin . Aide active À mourir: « le médecin accompagnateur n'est sûrement pas l'effecteur, ce n'est pas son rôle », selon le conseil national de l'ordre des médecins. Available: https://www.lequotidiendumedecin.fr/actus-medicales/ethique/aide-active-mourir-le-medecin-accompagnateur-surement-effecteur-ce-nest-pas-son-role-selon-le

5. Factors associated with requesting and receiving euthanasia: a nationwide mortality follow-back study with a focus on patients with psychiatric disorders, dementia, or an accumulation of health problems related to old age

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