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Table 2 Perceived complexities by SCEN physicians during the most difficult consultation, 2015

From: Complexities in consultations in case of euthanasia or physician-assisted suicide: a survey among SCEN physicians

Most difficult consultation N = 449* (%)
Patient characteristics79.7 
 No short-term life-threatening disease (e.g. accumulation of age-related health problems, chronic diseases, invalidity) 18.8
 Communication was difficult (e.g. coma, confused, not clear, aphasic) 18.4
 Psychiatric problems 13.5
 Ambivalence towards death wish 12.8
 Patient was demanding, angry 11.6
 Dementia, cognitive decline 10.7
 Patient was young 7.8
 Psychosocial problems (e.g. tired of living, loneliness) 5.8
 Time pressure due to medical state 2.6
Assessment of the due care criteria41.0 
 Suffering hard to assess due to the situation of the patient 11.8
 An early consultation 8.9
 Mental competence hard to assess 6.6
 Unbearable suffering hard to imagine 5.8
 Treatment options hard to define 5.6
 Suffering hard to asses due to lack of information (from patient/file/physician) 4.4
 Hard to assess whether the request was voluntary 1.5
Patient’s relatives26.3 
 Relatives aren’t ready for/have problems with the EAS 7.5
 Relatives exert pressure on the physician 5.6
 Problems within the family (not related to the EAS e.g. grief, no contact with children, family lives far away) 4.6
 Patient wants EAS together with partner 2.2
 Family cannot handle the care for the patient 2.2
 Patient provides care for children/partner 2.2
 Pressure from relatives on patient 0.8
Health professionals23.4 
 Pressure/not understanding doubts or judgement of the SCEN physician 8.9
 Doubting/unclear/unprepared attending physician 6.1
 Attending physician does not want to perform the EAS 2.4
 Attending physician was influenced by the patient and relatives 2.3
 Suboptimal care (e.g. too little care, not in place wished for, futile treatment) 2.3
 Attending physician already promised to perform the EAS 1.9
 Bad contact between attending physician and patient 1.7
 (Part of) health professionals are against EAS/agitation among health professionals 1.2
 Attending physician expected more counseling from the SCEN physician 1.0
 Attending physician seemed to want consultation/EAS earlier than patient 0.6
Other aspects13.4 
 An earlier SCEN physician judged differently 2.9
 Little experience of SCEN physician with disease 2.6
 Resistance of SCEN physician concerning a specific case 2.6
 Situation was moving 1.9
 Attending physician was also a SCEN physician 0.8
 SCEN physician acted awkward him/herself 0.6
 Questionable whether the second physician was independent 0.6
 Consultation with other SCEN physician necessary 0.6
 Other 1.5
  1. *More than 1 answer possible; 449 of 498 SCEN physicians answered this question