Aim of investigation: Though requests for Euthanasia (EU) are rare in palliative care they raise challenging ethical problems and conflicts when the caring team is confronted with individuals asking for premature life determination. Attentive sensitivity, respect and behavioural skills are needed for an adequate handling. Aim of our study was to investigate a social-psychologically based intergroup conflict approach when confronted with EU requests.
Methods: In 8 cases with repeated EU requests specific attention was given to seven steps of our intergroup conflict model: identification of the problem, acceptance of the conflict, analysis of conflict dimensions, determination of interests, reference to ethical values, conflict solution and consolidation. The consideration of ethical principles in conflict solution was related to a critical evaluation of the final phase. Exemplary cases are presented to demonstrate the systematic approach.
Results: The offering of comprehensive palliative care including the assurance of a quiet dying phase by the implementation of sedation in final stages and the orientation on a social-psychologically based intergroup conflict model can be useful in the management of EU requests in palliative care. The freedom to terminate their own lives in patients requesting EU must be respected but alternatives should be sought in a concerted effort.
Conclusions: The systematic intergroup approach with the possibilities of palliative care should be further evaluated in patients requesting EU in endof life conflicts. Acknowledgement: Respectful thanks to our patients and their relatives for the permission to present documents of their suffering.