Dutch doctors & dying: Do doctors’ personal views influence their professional care at the end of life – and should they?

This PhD-thesis is a reflection of the research Katja ten Cate has done from 2013 until 2018: studying physicians’ experiences with and personal views on end-of-life decisions, in particular physician-assisted dying. The thesis aims at providing more insights into the personal views of physicians on death and (assisted) dying, and also offers an ethical reflection on the influence these views have on the care physicians provide at the end of life. The thesis is a mix of empirical research and ethical reflection, and consists of three parts. Part 1 (chapter 2 and 3) is about end-of-life decisions for severely ill neonates (children 0-1 year) in general, and the decision to deliberately end their life in particular (DELN). Part 2 (chapter 4 and 5) is about Dutch general practitioners (GPs) and their views on euthanasia and assisted suicide (EAS) and good dying. Part 3 (chapter 6) is an ethical discussion in which the empirical findings presented in the previous chapters are reflected upon. In this chapter the central question is: ‘is it ethically justifiable that a physician’s personal viewpoints influence the care he provides for patients at the end of life, and to what extent?’ An additional question that is addressed is whether the answer to this question changes in case of an assisted death (EAS and DELN) in comparison with care surrounding a ‘normal’ death, and if so, why