Linguistic Analysis of Face‐to‐Face Interviews with Patients with An Explicit Request for Euthanasia, their Closest Relatives, and their Attending Physicians: the Use of Modal Verbs in Dutch

Dieltjens, Sylvain; Heynderickx, Priscilla; Dees, Marianne; Vissers, Kris

doi:10.1111/papr.12076

Cited by 9 publications

(13 citation statements)

References 16 publications

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“…16,19,21 HCPs’ demonstration of empathy, open-mindedness, and attentiveness positively influenced their interactions with the patients and family members. 21 –23 Engaging in discussions about assisted dying required HCPs to be comfortable with intense emotions. 24 Nurses found compassionate listening, actively engaging in the conversations, asking open-ended questions, and being transparent were critical to addressing patients’ and family members’ inquiries, expectations, and fears.…”

Section: Resultsmentioning

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: Resultsmentioning

confidence: 99%

Relational influences on experiences with assisted dying: A scoping review

et al. 2020

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“…A recent study by Dieltjens et al evaluating conversations between physicians and patients requesting physician-assisted suicide in the Netherlands 15 analyzed communication style at the level of grammatical expression. They reported differences between physicians in their usage of modal verbs.…”

Section: Discussionmentioning

confidence: 99%

The Language of End-of-Life Decision Making: A Simulation Study

Alexander

Mescher

et al. 2015

Journal of Palliative Medicine

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Background: Framing is known to influence decision making. Objective: The study objective was to describe language used by physicians when discussing treatment options with a critically and terminally ill elder. Methods: High-fidelity simulation was used, involving an elder with end-stage cancer and life-threatening hypoxia, followed by a debriefing interview. Subjects were hospitalist, emergency medicine, and critical care physicians from three academic medical centers. Measures were observation of encounters in real time followed by content analysis of simulation and debriefing interview transcripts. During the simulation we identified the first mention (''broaching'') of principal treatment options-intubation and mechanical ventilation (lifesustaining treatment [LST]) and palliation in anticipation of death (palliation)-and used constant comparative methods to identify language used. We identified physician opinions about the use of LST in this clinical context during the debriefing interviews, and compared language used with opinions. Results: Among 114 physician subjects, 106 discussed LST, 86 discussed palliation, and 84 discussed both. We identified five frames: will (decided), must (necessary), should (convention), could (option), and ask (elicitation of preferences). Physicians broached LST differently than palliation ( p < 0.01), most commonly framing LST as necessary (53%), while framing palliation as optional (49%). Among physicians who framed LST as imperative (will or must), 16 (30%) felt intubation would be inappropriate in this clinical situation. Conclusions: In this high-fidelity simulation experiment involving a critically and terminally ill elder, the majority of physicians framed the available options in ways implying LST was the expected or preferred choice. Framing of treatment options could influence ultimate treatment decisions.

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“…Nineteen articles, representing fourteen studies, met our inclusion criteria and were included in the review (4,7,(9)(10)(11)(18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30)(31). Ten studies (eleven articles) used a qualitative design (4, 7, 9-11, 18, 23, 24, 26-28).…”

Section: Resultsmentioning

confidence: 99%

“…Fourteen articles specifically investigated relatives' direct experiences. The remaining five articles' primary focus was on patients' or health care professionals' experiences or attitudes regarding assisted dying (7,(18)(19)(20)22). These articles used relatives as proxies.…”

Section: Study Characteristicsmentioning

confidence: 99%

“…Few families experienced feelings of regret over how the patient died (21). However, when professionals refused euthanasia, some families expressed gratitude that the death did not occur (18). Family members experienced some fears about assisted dying, such as being stigmatised by health care professionals or friends and being prevented from obtaining assisted dying (4,10,11,25).…”

Section: Emotional Workmentioning

confidence: 99%

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Family members’ experiences of assisted dying: A systematic literature review with thematic synthesis

et al. 2019

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Background: Families’ experiences of assisted dying are under-investigated and families are rarely considered in clinical guidelines concerning assisted dying. Aim: To systematically review family experiences of assisted dying. Design: A systematic literature review using thematic synthesis. Data sources: MEDLINE, Embase, CINAHL, AMED (Allied and Complementary Medicine) and PsycINFO databases (January 1992 to February 2019). Studies investigating families’ experiences on the practice of legalised assisted dying were included. We excluded studies prior to legalisation within the jurisdiction, secondary data analysis and opinion papers. Results: Nineteen articles met the inclusion criteria. Publications were derived from four countries: The Netherlands, United States (Oregon, Washington and Vermont), Canada and Switzerland. Dutch studies predominately investigated family involvement in euthanasia, while Swiss and American studies only reported on assisted suicide. Eleven studies had a qualitative design, using predominately in-depth interviews; seven were retrospective surveys. Five analytical themes represented families’ experiences in assisted dying: (1) context of the decision, (2) grounding the decision, (3) cognitive and emotional work, (4) experiencing the final farewell and (5) grief and bereavement. The results showed that families can be very involved in supporting patients seeking assisted dying, where open communication is maintained. Family involvement appeared to be influenced by the type of legislation in their country and the families’ perception of the social acceptability of assisted dying. Conclusion: Our data confirm that families across all jurisdictions are involved in assisted suicide decision and enactment. Family needs are under-researched, and clinical guidelines should incorporate recommendations about how to consider family needs and how to provide them with evidence-based tailored interventions.

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Linguistic Analysis of Face‐to‐Face Interviews with Patients with An Explicit Request for Euthanasia, their Closest Relatives, and their Attending Physicians: the Use of Modal Verbs in Dutch

Cited by 9 publications

References 16 publications

Relational influences on experiences with assisted dying: A scoping review

Relational influences on experiences with assisted dying: A scoping review

The Language of End-of-Life Decision Making: A Simulation Study

Family members’ experiences of assisted dying: A systematic literature review with thematic synthesis

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