The suffering of incurable cancer patients in general practice care and the request for and performance of euthanasia or physician-assisted suicide
01 / 2001 - 06 / 2007
[OBJECTIVES:] Unbearable and hopeless suffering is one of the conditions under which euthanasia or physician-assisted suicide (EAS) is allowed in the Netherlands. However, what makes this suffering unbearable and hopeless is unclear, as is the extent to which depression can be an underlying cause. Therefore, the following research questions will be addressed: What is the nature, prevalence and course of the suffering of cancer patients for whom no further curative treatment is possible in the final six months of their life? To what extent is the suffering unbearable and hopeless, and what makes it so? What is the prevalence, severity and course of depression? What causes differences in suffering, unbearableness, hopelessness and depression between patients who do and patients who do not request EAS? [METHODS:] In a prospective study carried out in 25 general practices, approximately 50 cancer patients, for whom curative treatment has no longer been possible for six months or less, will be included by their general practitioner. They will be interviewed at various points in time: on inclusion in the study, subsequently once every two months (or, if their situation severely deteriorates, once every three weeks), and when a request for EAS is made. Medical information about the patients will be obtained via a telephone interview with their general practitioner. The measurement instruments will be two internationally accepted instruments to measure suffering (EORTC QLQ C30 and the ESAS), two internationally accepted instruments to assess depression (HADS and SCAN) and a new measurement instrument that assesses how (un)bearable and hopeless the suffering is.