Table 5 Motives for (not) refusing to be engaged in euthanasia assessment procedures regarding APC (sort by frequency)

Motives for refusing to be engaged in psychiatric euthanasia procedures^a

1. Fundamental motives

Fundamental objections against euthanasia regarding psychiatric patients (ethical, moral, deontological reasons)

Euthanasia is incompatible with therapeutic relationship, but should be topic for further exploration in life track

Physicians should never give the sign to the patient of giving up hope

Law needs to be re-examined as criteria are unclear or need to be further restricted for this patient group

In that specific time, the euthanasia law was not yet effective

2. Ineligibility of the patient’s euthanasia request

Treatment options were still left, including non-medical treatment

Substantive legal criteria were not fulfilled

Personality disorder as contra-indication

3. Complex circumstances

Patient’s complex family situation

Patient’s young age

Not enough knowledge on the patient and her situation

Not enough competence to get actively involved

4. Experience of rehabilitation with former patients with withdrawn request

Motives for accepting to be engaged in euthanasia procedures concerning psychiatric patients^a

1. Fundamental motives

Fundamental right of the patient to ask for euthanasia

Fundamental task of the psychiatrist to take and discuss the request seriously

Opportunity to keep on searching for underlying meaning request and treatment options

2. Eligibility of the patient’s euthanasia request

Unbearable and untreatable suffering do exist

Specific task of the psychiatrist to be involved in the assessment

The euthanasia request is always based on misfortunes in many more domains in life