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Excess of bureaucracy and work overload, among the main reasons for discomfort among professionals in Catalonia when applying the euthanasia law

A study coordinated by IDIAPJGol researchers analyses for the first time the point of view of professionals in the application of the Spanish Law regulating the right to die with dignity, approved in 2021

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Photo: Ariadna Creus i Àngel García, Banc d’Imatges Infermeres

A study led by researchers from the Institut d’Investigació en Atenció Primària Jordi Gol (IDIAPJGol) has revealed the tensions and difficulties experienced by health and legal professionals in providing aid in dying in Catalonia. The work, published in the magazine Gaceta Sanitaria, concludes that bureaucratic stress and work overload are the main reasons for discomfort among professionals in the application of the Spanish Organic Law for the Regulation of Euthanasia (LORE).

The study has based on individual interviews and focus groups with a total of 29 professionals (medical, nursing, pharmacy, social work, psychology, spiritual support and law staff) who have participated in the provision of aid in dying. The results reveal that the process of providing this service is divided into four key moments: the reception of the request, the medical-administrative procedure, the provision itself and the closing of the process.

In welcoming the application, the doctors interviewed highlight the determination of the applicants, who have often reflected on their decision for years. On the one hand, this determination generates moral security in professionals, but, on the other, it makes them feel uncomfortable, since they perceive a contradiction between the capacity and autonomy of the applicant and the need to verify the compliance with legal requirements.

The research highlights that during the process, professionals may experience a feeling of helplessness or insecurity when their professional judgment is questioned by other professionals, especially in cases of applicants with a psychiatric diagnosis or other special situations.

In the medical-administrative procedure, professionals highlight the difficulties in finding the consulting doctor to issue the corresponding favourable report and other factors that can lengthen the process, such as family oppositions or vacation periods.

During the provision of euthanasia, professionals must manage the situation with the family, ensure the medication administration procedure and coordinate with the operating room in case of organ donation.

At the end of the process, many professionals express the need to rest and share their experiences with their colleagues, although some difficulties in communicating with other professionals may cause them discomfort.

The researcher at the IDIAPJGol’s North Metropolitan Research Support Unit, Xavier Busquet, who led the study, highlights that the work reveals “the need to address the sources of discomfort among professionals, whether administrative, emotional or moral, which must be addressed to guarantee access to this new right, the application of the law and the providing of adequate support to health professionals.”

Referència de l’article

Verdaguer M, Beroiz-Groh P, Busquet-Duran X, Moreno-Gabriel E, Arreciado Marañón A, Feijoo-Cid M, Domènech M, Íñiguez-Rueda L, Vallès-Peris N, Cantarell-Barella G, Toran-Monserrat P. La ley de eutanasia y experiencias profesionales: tensiones en la práctica clínica [The euthanasia law and professional experiences: tensions in clinical practice]. Gac Sanit. 2024 Mar 11:S0213-9111(24)00020-7. Spanish. doi: 10.1016/j.gaceta.2024.102373. Epub ahead of print. PMID: 38472012.