What would you ask a doctor who has conducted dozens of assisted suicide
February 1, 2019 3:37 AM   Subscribe

I have the opportunity to interview (for a news article) a doctor who, because of his specialty with terminal disease, has conducted dozens of assisted suicides in his career for his patients, mostly in their homes. I would like to ask questions that reveal the emotional challenge that comes with doing a job like this. Given the sensitive content the doctor tends to be guarded, so I need different ways to ask this question to open him up. What would you ask?
posted by Jason and Laszlo to Health & Fitness (14 answers total) 3 users marked this as a favorite
 
maybe ask about his mental/emotional opening stance? "I am inclined to do it unless/until I hear something that turns me from the decision" or "I am not inclined to it to begin with and need to be convinced/persuaded by the patient's circumstances".
posted by alchemist at 4:09 AM on February 1 [1 favorite]


If the doctor is guarded about his own experience, I would start by focusing on his practical experience and use logical, "thinking" terms. For example,
- How has your practice changed since you began doing the work?
- How has your other work changed as a result of this work?
- What changes in medicine, politics, insurance have affected your work? Where do you see changes coming in the future that will impact your work?

But overall I would be pretty straightforward. If you sense he's getting cagey, I would move the questions up a meta level: "I sense you have some guardedness in talking about the work. Can you explain why that is?" And tease out the breadcrumbs you can from that.

To get more at his own beliefs and feelings, you might ask him to either retell or guess what his patients and their families go through, and then springboard from those into his own feelings.
- What challenges do patients go through before and up to the point of death? What about their families?
- How do patients and families relate to your role?
- Has anything surprised you about how patients and families relate to you or encounter your role?
- How do you relate to patients and their families over the course of your care for them?
- What helps you in the work you do? What gets in the way?
- Thinking about a few patients where things went 'well' what was it about those situations that made it the best possible outcome? Thinking about a few situations that were especially challenging, what do you think it was about them that made them challenging?
- In what ways have you adapted, changed, or grown as a physician as a result of this work?
- How does the work affect you personally?
- What did you originally think about death/dying/assisted suicide before you started this work? What do you think now?
- Has this work challenged, changed, or solidified any of your own beliefs about practicing medicine? About dying? About human nature? About death?
- What kinds of doctors do well in this work? Which don't?
- In what ways were you prepared for this work (either through formal channels or personally)? In what ways were you unprepared?
- What advice would you give other doctors about going into this field or doing this work?
posted by cocoagirl at 4:11 AM on February 1 [17 favorites]


Oh, two other possibly revealing questions: what got you into this work and what keeps you doing it?
posted by cocoagirl at 4:20 AM on February 1 [5 favorites]


I would definitely think about the language being used in this area. In particular, words like 'suicide' and 'euthanasia' have become very emotionally loaded terms that you might want to avoid. Use empathy rather than challenge to encourage this person to open up. cocoagirl's questions are good.
posted by pipeski at 4:41 AM on February 1 [2 favorites]


I would go for just acknowledging that it's a sensitive subject but one that you're very curious about, and ask them what they are comfortable sharing about it - how they view patient care, how end of life decisions are a part of that, how families relate to it. Maybe also what history he's looking at, since euthanasia is not a new idea at all and many medical providers over time have participated in it.
posted by bile and syntax at 5:59 AM on February 1 [1 favorite]


I would want to know "Prior to ending their lives, what if anything do your patients typically want to have happen one last time?"
posted by Patapsco Mike at 6:20 AM on February 1 [1 favorite]


The hardest thing in interviewing is allowing wait time, particularly when we sense the interview subject is in emotional distress.

It will feel easiest for you to have a whole toolkit of questions that expertly open your subject up. But you will have a much better outcome if you just say: “Tell me about your practice” and stay silent, even when your subject falls silent.

People like to unwind themselves, not be unwound by someone else. So have a few basic questions and wait, wait, wait.
posted by argybarg at 6:26 AM on February 1 [13 favorites]


"how involved are their spouses and relatives?" "what do you typically hear from spouses and relatives?"
"do patients share their decision making with you? what do they say?"
posted by fingersandtoes at 7:06 AM on February 1


Toward the end of the interview:

1. Many people are strangers to this type of work. What might they find most surprising about what you do or have learned over the course of your career?

2. What important question or aspect of this issue have I failed to ask? Have I forgotten anything?
posted by Bella Donna at 7:35 AM on February 1 [7 favorites]


Consider that he may be guarded because getting featured in a news article may not be so great for him. Offer to use him anonymously.
posted by intermod at 8:44 AM on February 1 [6 favorites]


I want to reiterate pipeski's comment that the language around this is very fraught and may be part of why your prospective interviewee is guarded.

Here is a language guide from an organization that does this sort of work. They suggest "assisted death" (which is the terminology used by the American Association of Hospice and Palliative Medicine).

I like the prompt "Tell me about your practice/how your practice has changed over the years," because it can go a lot of different ways. While there can be great sadness at the end of life, there can also be great joy or kindness. Maybe there's that one patient this doctor interacted with as a medical student, or a personal story, that brought them into the end-of-life arena, and if so that will emerge. Personally, what I would want to know is "how do you approach these conversations with patients and their families?" -- often, having the conversation feels more tense than carrying out the actual actions.
posted by basalganglia at 9:43 AM on February 1 [3 favorites]


Also: If you are a freelancer rather than a staff writer, consider asking the source for permission to use the interview for other articles/publications (or ask if he is open to being quoted in future articles). This is a fascinating topic. If the interview goes well, I can imagine several other articles growing out of this single interview for different publications with different audiences. It is so hard, as you know, to make money as a writer so it might be helpful if you could use the interview in several different ways. Also, please post in Projects later if you are willing. I would love to read your article after it is published. Good luck, OP!
posted by Bella Donna at 10:03 AM on February 1 [2 favorites]


I would encourage you to read this study of nurses' experience of medical assistance in dying (MAID) to help you frame your questions a little more specifically. There are a few wording choices in your question that I would be careful about - assisted suicide has been pointed out but "the emotional challenge" is another one - some practitioners involved with medical assistance in dying have positive emotions around being pioneers, respecting patient choice, etc. There isn't necessarily one singular emotional challenge.

You might also frame a question around a study done in Quebec Decoding Conscientious Objection in Medical Aid in Dying (December 2017, pg 36 - it's in english) where physicians did object to performing the procedure based on emotional toll on them, and ask what this physician's experience has been in relationship to that article. I think it's a lot to ask an individual to bare their emotional soul, but if you professionalize the question in terms of what doctors in general might have to grapple with, or their teams, you might get to the core that it sounds like you're looking for.
posted by warriorqueen at 10:26 AM on February 1 [3 favorites]


Similar to Bella Donna's points, but a slightly different way of putting a question I often ask when interviewing people with very specialized knowledge/experience of a field: "What do you most wish other people/the public understood about what you do?"

Also, a good starting point for the conversation is to ask them to describe their work in a more specific, practical kind of way: i.e. "Walk me through what a day in your job is like" kind of prompts, which often end up eliciting not just factual info but also a lot about their perspectives and attitudes, and opening up avenues for deeper questions.
posted by karayel at 3:44 PM on February 1 [2 favorites]


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