Belgian doctors view euthanasia objection as flexible practice

A qualitative study published in BMC Palliative Care reveals that palliative care physicians in Belgium perceive conscientious objection to euthanasia as a dynamic moral practice rather than a categorical refusal. The research, conducted by Carlos Gomez-Virseda, Diego Real de Asúa, and Chris Gastmans, challenges the conventional framing of conscientious objection as a principled refusal based on fixed moral or religious convictions. Instead, the findings indicate that many physicians experience the term as contested and value-laden, often distancing themselves from assumptions that objection entails a complete refusal of care or opposition to the law.

The study was set in Belgium, a country with more than two decades of regulated euthanasia practice. The researchers aimed to explore how conscientious objection is understood and enacted in clinical practice, noting that existing frameworks may not fully capture the nuances of professional integrity and patient access.

Using a constructivist grounded theory approach, the team conducted semi-structured interviews with 24 physicians trained in palliative care. These participants were working in Belgian palliative care units and were recruited through purposive sampling. The interviews took place between March and December 2025. Theoretical sampling was used to refine emerging concepts.

Data analysis was performed using the Qualitative Analysis Guide of Leuven, known as QUAGOL. This method involves an iterative process of coding, constant comparison, and conceptual development.

The results showed that physicians’ perceptions often diverged from traditional definitions of conscientious objection. Many participants rejected the idea that objection implies a static moral position. Instead, they described their refusals as embedded in ongoing care relationships. The decision to object was frequently involved in the interpretation of legal criteria and was negotiated on a case-by-case basis. Conscientious objection to euthanasia emerged as a dynamic moral practice that was evolving, interpretive, relational, and context-sensitive.

Participants favored flexible, compromise-oriented approaches to handling requests for euthanasia. They expressed reservations about binary regulatory models.

The findings underscore the limitations of binary understandings of conscientious objection in healthcare. The findings support clinical and institutional approaches that balance professional integrity, patient relationships, and continuity of care.

Subject of Research: Conscientious objection to euthanasia: a qualitative study of palliative care physicians’ perceptions

Article Title: Conscientious objection to euthanasia: a qualitative study of palliative care physicians’ perceptions

Article References: Gomez-Virseda, C., Real de Asúa, D., & Gastmans, C. (2026). Conscientious objection to euthanasia: a qualitative study of palliative care physicians’ perceptions. BMC Palliative Care. https://doi.org/10.1186/s12904-026-02366-9

Image Credits: AI Generated

DOI: 10.1186/s12904-026-02366-9

Keywords: Conscientious, objection, euthanasia, qualitative, palliative, care, physicians, perceptions, scientific research