In places where both euthanasia and assisted suicide are forbidden by law, such as France, almost nothing is documented about the way an end-of-life patient’s explicit request for these acts influences the patient’s family members. To examine the personal experiences of family members whose loved ones are in the final phases of a life-threatening disease, admitted to a Palliative Care Unit (PCU), and who have asked for euthanasia or assisted suicide, all within the French setting in which these procedures are not legally allowed. We conducted a qualitative investigation across five French PCUs over a full 1-year period. Applying grounded theory principles, we carried out semi-structured interviews with relatives of patients who had directly voiced a request for euthanasia or assisted suicide to medical staff. Two separate interviews were arranged: the initial one within 48 hours of the first request (D1) and the follow-up interview 7 days afterward (D7). Detailed face-to-face conversations were held with relatives of patients seeking euthanasia or assisted suicide. These took place in PCUs located in a specific area of France and occurred before the enactment of the French Claeys-Leonetti Law. The data underwent thematic analysis.
A total of ten semi-structured interviews were completed. Five families, comprising the patients and their relatives, participated in the research, resulting in 8 relatives being interviewed. Talks held between the patients and their family members regarding the request for euthanasia or assisted suicide differed markedly depending on the family. Five central themes surfaced: criticizing the conditions at the end of life; longing for a calm and serene death; differing extents of backing and help offered for the request; personal beliefs that endorse euthanasia and assisted suicide; and limits together with obstacles. Family members generally show understanding toward requests for euthanasia and/or assisted suicide. Even so, accepting and discussing such demands is a tough, emotionally heavy responsibility that can create considerable strain. Virtually every relative goes through some form of distress, yet the manner in which this distress appears can vary widely from person to person. We recommend that healthcare staff recognize the specific nature of this distress and encourage both patients and their relatives to speak openly about these concerns while addressing the request in an active, forward-looking way.
