medical research volunteer

• Clinical Trials

Volunteering

Volunteers are an integral part of the research process. People with a particular disease as well as healthy people both can play a role in contributing to medical advances. Without volunteers, clinical studies simply would not be possible.

People volunteer for clinical studies for many reasons. They may have a:

• Desire to improve medical care for future generations
• Connection to a certain disease or illness, whether through personal experience or through friends or family
• Personal interest in science

Participating is a choice

Volunteering for a clinical study is a personal choice. You have no obligation to do so, and participation is not right for everyone. After enrolling in a study, you may leave at any time for any reason.

Getting involved

• Participate in a clinical study at Mayo Clinic. By better understanding how to diagnose, treat, and prevent diseases or conditions, we help people live longer, healthier lives. Researchers need volunteers for a broad range of clinical studies. Find a clinical study .
• Connect with us. Eligibility requirements vary for each study and determine the criteria for participation. There is no guarantee that every individual who qualifies and wants to participate in a trial will be enrolled. Connect with the study staff directly as they are in the best position to answer questions and provide specific information regarding eligibility and possible participation. Contact information is found in each study listing.
• Join a national research volunteer registry. Health research changes peoples’ lives every day, but many studies end early because there are not enough volunteers. Researchers need both healthy people and those with all types of conditions. Funded by the National Institutes of Health, ResearchMatch is a first-of-its-kind registry that connects research volunteers with researchers across the country. Sign up at ResearchMatch.org .

Making an informed decision

• Informed consent. Before deciding to participate in a study, you will be asked to review an informational document called an informed consent form. This form will provide key facts about the study so that you can decide if participating is right for you. You must sign the informed consent form in order to participate in the study, though it is not a contract — you may still choose to leave the study at any time.
• Risks and benefits. All medical research involves some level of risk to participants. Risks and benefits vary depending on the particular study. To help you make an informed decision, the study team is required to tell you about all known risks, benefits and available alternative health care options.
• Ask questions. If you have questions when deciding to join a research study or at any time during it, ask a member of the study team. If your questions or concerns are not satisfactorily addressed, contact the study's principal investigator, the Mayo Clinic research subject advocate or the Mayo Clinic Institutional Review Board (IRB).

Protecting rights and safety

An independent group, the Mayo Clinic IRB , oversees all Mayo clinical studies that involve people, ensuring research is conducted safely and ethically. Members of the Mayo Clinic IRB include doctors, scientists, nurses and people from the local community.

In addition, Mayo Clinic has a research subject advocate who is independent of all clinical studies and is a resource for research participants. Contact the research subject advocate by email or at 507-266-9372 with questions, concerns and ideas for improving research practices.

Participation costs

Clinical studies may involve billable services and insurance coverage varies by provider.

Clinical studies questions

• Phone: 800-664-4542 (toll-free)
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Cancer-related clinical studies questions

• Phone: 855-776-0015 (toll-free)

International patient clinical studies questions

• Phone: 507-284-8884
• Email: [email protected]

Clinical Studies in Depth

Learning all you can about clinical studies helps you prepare to participate.

Diversity in Clinical Trials

Mayo Clinic is keeping diversity and inclusion in focus for all clinical trials and addressing barriers to enrollment.

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The Institutional Review Board protects the rights, privacy, and welfare of participants in research programs conducted by Mayo Clinic and its associated faculty, professional staff, and students.

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Patient Recruitment

Healthy volunteers.

Clinical research and medical discovery depend on volunteers who participate in clinical research studies.

What's a "healthy volunteer"

Someone with no known significant health problems who participates in research to test a new drug, device, or intervention is a "healthy volunteer" or "Clinical Research Volunteer".

Research participants include healthy volunteers and patient volunteers

Healthy volunteers provide researchers with crucial data because their health information can be used as a comparison. In some studies, researchers need to compare healthy volunteers with people who have a specific disease or condition. Research with healthy volunteers is designed to develop new knowledge, not to provide direct benefit to study participants.

Healthy volunteers have always played a vital role in medical research. When developing a new technique such as a blood test or imaging device, we need clinical research volunteers to help us define the limits of "normal."

These volunteers are recruited to serve as controls for patient groups. They are often matched to patients on such characteristics as age, gender, or family relationship. They are then given the same test, procedure, or drug the patient group receives. Investigators learn about the disease process by comparing the patient group to the clinical research volunteers.

Why are healthy volunteers needed for clinical research?

There are many reasons. When developing a new technique such as a blood test or imaging device, we need clinical research volunteers to help define the limits of "normal." Healthy volunteers are often matched to patients so that certain characteristics such as age, gender, or family relationship, are similar. Healthy volunteers are given the same test, procedure, or drug that the patient group receives. Investigators learn about the disease process by comparing the patient group to the clinical research volunteers.

How can I volunteer?

One way to volunteer is to join the registry for the Clinical Research Volunteer Program. The program, created in 1995, is a resource that helps match potential research volunteers to clinical research studies at the NIH Clinical Center. To participate in the registry, we'll ask you to provide some basic information and give us permission to share that information with the research teams. If you are a potential match to a study's requirements, the study team will contact you.

How do I enroll myself or my child?

You can contact us at 301-496-4763. Parents or guardians must call to register anyone under 18 years of age.

How do I find studies for healthy volunteers?

To find studies for healthy volunteers go to http://clinicalstudies.info.nih.gov/ and search for studies using the word healthy . When you select individual studies, carefully review the study overview and eligibility requirements. If you meet the eligibility requirements, call 1-800-411-1222 (TTY 1-866-411-1010). We can provide participation details on up to three studies a day.

Ask about joining our Clinical Research Volunteer Program registry. To participate in the registry, we'll ask you to provide some basic information and give us permission to share that information with the research teams. If you are a potential match to a study's requirements, the study team will contact you.

Choosing to participate in a clinical trial is an important personal decision. For more information and answers to frequently asked questions about participating in clinical research, visit http://www.cc.nih.gov/participate.shtml . Compensation may be provided.

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Participate in Clinical Research

Millions of people volunteer to take part in clinical research every year. Their participation helps the medical community learn what works best in preventing and treating diseases. If you’re serious about volunteering, it’s important for you and your family to understand the process and your part in it.

Clinical trials are medical research studies performed with the help of patients who volunteer to try new diagnostic techniques or new therapies, or to be observed as part of a group of people with a specific health issue. The doctors conducting the research seek to answer specific medical questions — ultimately to improve health and patient care. Diversity in clinical trial participation helps ensure new treatments are safe and effective for all people. Learn more about why diversity in clinical research matters here .   

Researchers can gather information for clinical trials using a variety of methods, including:

Interventional

Participants receive experimental treatment — which can include a drug, device, surgical procedure or an existing therapy used in a new way — to determine whether it’s safe and effective.

Observational

Participants receive diagnostic or therapeutic care through their regular care providers and researchers observe and note the health outcome, sometimes through review of patient medical charts.

Chart review

Doctors use data from existing patient health charts to answer the research question.

Researchers study a specific patient population by observing participants with a particular disease, condition or exposure to something that may be affecting their health.

Specimen collection and research repository

Participants donate biologic samples for analysis, including blood, solid tissues, cells, cell cultures or molecules derived from tissues — such as DNA, RNA and proteins — and body fluids. Participants may consent to use of their samples for a particular study or for unspecified future research or testing.

Before joining a clinical trial, you must meet the specific qualifications of the study. Each study has a different set of criteria to help ensure that researchers can answer the health question they plan to investigate. Trial criteria may include age, sex, the type and stage of the disease, and previous treatment history.

Types and Phases of Clinical Trials

Clinical trials can be used for much more than testing new drugs. Types of clinical trials include:

• Treatment trials  – Test new drugs, devices, therapies or surgical techniques.
• Prevention trials  – Look for ways to prevent disease.
• Diagnostic or screening trials  – Find better tests for identifying or screening for certain health conditions.
• Quality of life trials (or supportive care trials)  – Explore ways to improve quality of life for people living with chronic disease.

Drug Trial Phases

For the study of new drugs, or of existing drugs used in new ways, pre-clinical and clinical trials are divided into different phases, numbered from 0 to 4. The earliest phases may look at safety or side effects. A later phase may test whether a new treatment is better than existing treatments:

Pre-Clinical

Research using In Vitro (i.e., test tube or petri dish) or In Vivo (i.e., live organism/animals) to find out if a drug, procedure, or treatment is likely to be useful. Preclinical studies take place before any testing in humans is done.

An exploratory study that requires very limited human exposure to the drug and has no therapeutic or diagnostic goals.

Conducted with an emphasis on safety, the goal is to discover how the drug is processed, toxicity and any side effects.

Gathers preliminary data on effectiveness — whether the drug works in participants with a certain condition, compared with participants receiving a different treatment or a placebo (a medicine that has no effect). 

Measures safety and effectiveness by examining different populations taking different dosages of the drug or in combination with other drugs.

Phase 4 

Occurs after the Federal Drug Administration (FDA) has approved a drug, but researchers want more information about its safety, efficacy or best use.

Medical Device Trial Phases

Clinical trials are also used to test medical devices — healthcare products that don't achieve results through chemical action or by being metabolized. A device can range from something as simple as a tongue depressor or thermometer to a complex instrument, such as a specialized heart valve or robotic surgical device. Device trial phases include:

• Pilot/Feasibility  – May be used to answer basic research questions or provide support for a future study. It's an initial, exploratory stage to determine whether the potential benefit justifies any risk.
• Pivotal  – Evaluates the safety and effectiveness of the device for the intended use, which may require one or more studies. 
• Post-market  – Assesses safety of the device after it’s been used commercially, such as investigating rare adverse events or long-term effectiveness. 

Observational Studies

Some studies do not involve receiving a treatment as part of the study. Instead, they are meant to identify individuals belonging to specific groups and assess them for health outcomes. These studies may involve responding to questionnaires and/or providing biologic samples (such as blood). They may involve a single study visit or multiple visits, such as following up with you at different times throughout a treatment you’re receiving from your regular doctor.

Research Study Funding and Leadership

The people or organizations that initiate studies are known as research sponsors. Doctors, medical institutions, foundations, voluntary groups, device and pharmaceutical companies sponsor medical studies. Federal agencies such as the National Institutes of Health (NIH), the Department of Defense (DOD) and the Department of Veterans Affairs (VA) also sponsor research. Trials can take place in hospitals, universities, doctors’ offices or community clinics.

Every study has a principal investigator, or lead researcher, who takes direct responsibility for completion of a clinical trial. The principal investigator directs the research and reports to the sponsor.

Informed Consent: Know Your Risks and Costs

Clinical trials aren’t always free and may include risks, even though they’re carefully controlled. Every trial is different. When it comes to cost, some studies will be fully funded, while others will be billed to your insurance company; a combination of both is also a common occurrence.

“Informed consent” is a process of learning key facts about a trial before participating. It’s also a document. Once your doctors and nurses are certain you fully grasp the details — a study’s purpose, procedures, risks, costs, potential benefits and how long it will take — you’ll be asked to sign an informed consent document. It’s not a contract and it’s not binding . You may withdraw from a trial at any time .

How to Find a Clinical Trial

The Center for Information and Study on Clinical Research Participation (CISCRP) educates and informs the public, patients, medical and research communities, the media, and policymakers about clinical research and the role each party plays in the process. They offer a free search service to help you  find a trial that’s right for you .

How to Express Interest in a Study

Trial listings often include a “Contact Us” option to submit contact information if you or a loved one is interested in learning more about whether a clinical trial is right for you/them.  A few tips:

• Expressing interest should include basic contact information (“Dear Study Team - Please contact me to determine if this study is a good fit for me/my loved one.”).
• When coordinating a follow-up call with the study team, they may ask you to discuss medical history that can be found in your health records.  Being prepared to discuss this information is helpful.
• In some cases, you may be asked to authorize access to your medical records to enable the study team to confirm eligibility.  They will ask you to sign a “Medical Records Release Form” or “Authorization for the Release and/or Discussion of Protected Health Information.”  Please read these forms carefully.

Email: [email protected] Phone: 617.414.7090

Volunteering at UW Medicine

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Experience caring in action

Volunteers are an essential part of our healthcare team. Their dedicated service helps us achieve our mission to improve the health of the public. Their care and commitment makes an indelible impact on our diverse group of patients, families and medical staff.

Our volunteers get to see world class healthcare in action while they learn new skills. Volunteers also find that working with patients gives them the meaningful satisfaction of helping others while learning customer service and professional skills at the same time.

Volunteers help create a welcoming environment for patients and visitors alike by supporting a variety of vital activities within the immediate community. The services offered by our volunteers enrich the overall community and each unique individual within it.

Volunteering at University of Washington Medical Center - Montlake Campus

Thank you for your interest in the UW Medical Center Volunteer Program. Since 1959, University of Washington Medical Center patients, families, guests and staff have benefited tremendously from the commitment of community members and individuals who volunteer at the UW Medical Center.

Volunteers add to the quality of care and service provided to our patients by supporting our "UW Medicine Patients Are First" culture and providing more than 60,000 hours of service each year in more than 70 roles throughout UW Medical Center and UW Medical Center - Roosevelt Clinics.

Volunteer opportunities

Opportunities are currently available four our patient Escort position.  We expect more positions to open in the near future. Volunteers are required to complete a one-month term (16 hours of service) pre-requisite as a patient escort before they are eligible for new assignments.

Patient Escorts

Be a part of our highly regarded team who transport, greet and welcome visitors and patients to UW Medical Center. Our patient escort volunteers are stationed in the dispatch area and work directly with resource team and patient transport staff to assist with the following tasks: Level Green wheelchair transport, specimen deliveries, wheelchair rounding, patient discharges, delivering patient flowers and mail, and creating a warm and welcoming environment for our patients and visitors.

Volunteers receive training on safe wheelchair handling and patient transport, customer service and patient confidentiality. The escort role provides volunteers with an opportunity to work directly with patients while also experiencing the hospital environment in a leading regional and metropolitan acute care facility. In these roles, volunteers become familiar with the diversity of care and services provided at the hospital while experiencing the highest level of patient contact of any volunteer position offered at UW Medical Center. This role provides excellent baseline training to prepare volunteers for other patient care volunteer opportunities.

Retired Adult Volunteers

Please contact Volunteer Services at  [email protected]  to inquire about upcoming opportunities.

Summer Teen Program

The 2024 UWMC Summer Teen Program applications are now CLOSED. For the 2025 program, please check back here in early spring next year. Thank you. 

Getting started

Thank you for your interest in the UWMC Volunteer Program at Montlake. Applications are temporarily closed until further notice. Please check back in the Fall for availability. Thank you for your patience.

Questions? Please email the Volunteer Services team at [email protected]

Contact information

If you have further questions about the UWMC Volunteer Programs at Our Montlake and Northwest campuses, please email us at  [email protected]  and a Volunteer Services team member will respond to you. Thank you.

Eligibility and time commitment

Adult/College Program: All applicants must be 18 or over and a high school graduate.  All eligible volunteers must complete an application, attend an interview, be screened by Employee Health and comply with all required immunizations, and complete all required training, both written and practical.   Volunteers are required to make a minimum commitment of four hours per week for three months.

Summer Teen Program: This is a summer only program that provides exposure to healthcare careers and service for our community high school students.

Please note: Our volunteer program does not accommodate job shadowing, internships, court ordered service, or job training programs.​ In addition, our program is not intended for those with medical training above a CNA.

Current Volunteers

 Look for updates here soon.

Frequently asked questions

Discover the answers to common questions asked about volunteering at UW Medical Center.

Volunteering at Harborview Medical Center

The care and dedication of our volunteers has a great impact on our diverse group of patients, families and staff. Volunteers at Harborview Medical Center have the chance to:

• Gain experience in a hospital setting, working side by side with leading healthcare professionals
• Observe patient care in a high-volume medical center
• Gain satisfaction from helping others
• Build meaningful relationships
• Give back to the community

As an academic medical center, Harborview promotes a culture of education. If you are considering a career in healthcare, volunteering at Harborview is one of the best experiences you can have.

Harborview volunteers are an essential part of the Harborview community.   Volunteer placement is dependent on the applicant's work history and volunteer experience, as well as the needs of the hospital. Applicants with no prior work or volunteering experience in a healthcare setting will usually be required to complete a 3-month term of 50 hours of service at our Information Desk. Opportunities are variable but generally are available between 8 a.m. and 5 p.m. weekdays. Please refer to our Opportunity Directory for a list of commonly available departments. Please keep in mind that we will place volunteers based primarily on the needs of the hospital and that we cannot guarantee any applicant a position in a certain department. Typical volunteer duties include:

• Restocking supplies in inpatient units
• Providing non-medical comfort to patients
• Preparing rooms for new patients
• Providing administrative support in medical offices
• Reading to patients
• Changing bed linens
• Answering patient calls
• Socializing with patients, speaking with patients in another language
• Escorting non-critical patients to clinic appointments
• Directing patients' families and friends to hospital units, clinics, or other destinations
• Distributing books, magazines and activities to patient rooms and waiting areas

Thank you for your interest in the Harborview Medical Center Volunteer Program. Please complete the Volunteer Interest Form ( https://forms.office.com/r/k8TJT9741t ) and we will follow up with you soon.

Questions? Please email the Volunteer Services team at [email protected] .

Volunteer Services Harborview Medical Center 325 Ninth Ave Seattle, WA 98104  Box 359788

Email: [email protected] Phone: 206.744.3547

Program applicants must be at least 16 years old to volunteer at the Information Desk and 18 or older for inpatient units and in clinical areas.

The commitment for our program is four hours per week for at least six months. Volunteers may continue beyond six months, if they maintain at least 4 hours per week of service.

Discover the answers to commonly asked questions about volunteering at Harborview.

University of Washington Medical Center – Northwest Campus

Have you ever had to wait while a loved one has surgery? Then you know how comforting it is to have a volunteer keep you company in the waiting room. Have you ever gotten lost on your way to treatment or another area of the hospital? Then you know what a relief it is to see the friendly face of a volunteer who took the time to take you where you were going. Have you ever been hospitalized? Then you know how uplifting it is when a volunteer comes by with magazines, flowers or just a hello. 

Every day, everywhere in the hospital, volunteers add to the caring environment at University Medical Center - Northwest, helping patients and their families at a stressful and sometimes frightening time in their lives. By volunteering your time, you help give back to your community and make University Medical Center - Northwest a friendlier, more welcoming place to everyone who steps foot on our campus.

More than 150 active volunteers of all ages perform a wide variety of tasks at the hospital. For example, volunteers work in the hospital’s gift shop, bring the library cart to patients’ rooms, escort discharged patients and provide information and comfort to families of inpatients and those undergoing surgery. In fact, volunteers can be found in departments throughout the hospital.

While most volunteers work during the weekdays between 8 a.m. and 5 p.m., some volunteers choose to work evenings and weekends.

Thank you for your interest in the UWMC Volunteer Program at Northwest. Applications are temporarily closed until further notice. Please check back in the winter for availability. Thank you for your patience.

If you have any questions, please email  [email protected]  and a Volunteer Services team member will respond to you. Thank you for your patience and we look forward to working with you all again soon!

More information coming soon.

Volunteering at Valley Medical Center

Valley Medical Center volunteers are an integral part of its healthcare team and valuable contributors. Volunteer opportunities are available within different departments and roles throughout the organization.

Volunteer for medical research

By volunteering to participate in medical research, you help researchers learn more about specific medical conditions and the effectiveness of treatments. Studies usually focus on diagnosing, preventing, treating or improving symptoms of a disease, injury or condition. Both healthy volunteers and participants with specific health conditions are needed.

Requirements for volunteering in our hospitals

All UW Medicine volunteers are required to be immunized, screened for tuberculosis and pass a background check.  In addition, volunteers must maintain the highest level of patient confidentiality.

Health Screening

• All volunteers need to provide evidence of immunity against varicella (chickenpox), measles, mumps and rubella (MMR), and tetanus, diphtheria and pertussis (Tdap).  This may be in the form of vaccinations or lab testing.
• Hepatitis B vaccination is not required for volunteers.
• Annual flu vaccination is required for all volunteers.
• TB skin testing is required at orientation and annually. Some volunteers may need two TB skin tests (an initial test and a repeat test) when first starting their volunteer orientation.
• Health screenings, flu vaccinations and TB skin testing are provided free of charge to volunteers. 

Background Check

• All volunteers are required to pass a Washington state criminal conviction history background check before volunteering. To complete the background check, potential volunteers must complete a criminal conviction history form at the time of obtaining their volunteer badge, along with submitting a photocopy of a government issued ID (driver’s license, state ID, passport).
• If you have any prior criminal convictions, please contact the appropriate volunteer services office at the time of application so we can discuss this with you, as it may or may not disqualify you depending on the type of conviction and how long ago it occurred.

Patient Confidentiality

Volunteers must comply with patient confidentiality and HIPAA compliance standards. Training is provided during volunteer orientation. Volunteers who violate HIPAA guidelines will be subject to termination.

Home » What to Expect From Our Volunteer Research Opportunities » Volunteer And Get Paid For Clinical Trials

Volunteer And Get Paid For Clinical Trials

Seize the chance to serve, while getting paid.

If you’re a student or a young individual who wants to earn extra income while finding purpose in service, becoming a volunteer of a paid clinical trial is a great way to achieve both objectives. Being a participant in a medical research study will surely add a sense of fulfillment and purpose to your life.

Biotrial offers a meaningful way to spend your time while earning money. Becoming a paid clinical trial volunteer is easy! Just register to be a participant for one of our online research studies and you can start getting paid during your first screening appointment.

By participating in our healthy studies, you offer hope for many people as you contribute to medical advancement. Our volunteers not only get involved in medical trials for money, they are also here for a purpose – an opportunity to help researchers find better treatments for diseases. In return, we provide compensation as a reward for your courage and contribution to the betterment of our medical state.

Why become a volunteer?

Get compensated for your time.

There are no out of pocket costs to participate in a study, instead, you get paid for doing them. All costs – from your travel expenses to your examination and medication, are covered by the sponsoring organization or individual. You will also get paid for studies as compensation for your time and service. The amount of payment you receive depends on several factors, including the type of trial, the length of your stay, and the number of times you visit the ambulatory. All participants will get paid for the studies they are involved in. Payment details, as well as other pertinent information, will be sent in an informed consent document.

Know that your safety comes first

Biotrial conducts Phase 1 and sometimes first-in-human studies with the highest standards of safety. Clinical trials have always been the cornerstone of medical research under the utmost condition that the safety of participants is ensured at all time. Since most of our clinical studies are in phase 1, we welcome healthy volunteers. A healthy volunteer is someone with no known illness and who is not taking any medication. It is their contribution that greatly impacts the future recipients for which these medicinal products and devices are intended.

Get the reward of helping others

At Biotrial, we consider our volunteers as modern research heroes. When you participate in a medical trial, you are doubly compensated. You get a monetary benefit, and you allow medical research to advance. In a few words, you take part in significant, life-saving causes. You might have a relative with a disease and want to help them. By joining Biotrial trials, you’ll gain a unique and empowering experience. Many of our volunteers report a sense of compassion and fulfillment after participating in our medical studies.

Learn about your health

Every year, hundreds of volunteers complete our onsite medical studies and get to know their medical condition much better. These individuals get frequent health check-ups and close monitoring of their body metabolism. During their stay, they have easy and frequent access to medical doctors and can ask all the questions they want. It is an opportunity to learn about a healthy diet and better understand medical diseases. Our clinical studies also offer the opportunity to better understand science and get more knowledge about diabetes, cancer, heart disease, and other illnesses that plague humanity.

We are looking for healthy volunteers who want to make a difference and get paid for research studies.

We need healthy men and women 18 to 80 all year round to become volunteers for our Phase I paid clinical trials.  Our medical research studies compensate your time and effort. Register now to participate.

Sign up to become a clinical volunteer!

Complete the registration form and call us at 844-246-8459 . Our recruiters will be happy to help you, and it will take 5 minutes of your time to know if you are eligible. Your information will be kept strictly confidential.

OHSU Visitors and Volunteers

Volunteer opportunities in research, shadow opportunities restricted.

Currently, high school students and undergraduates who want to observe clinical operations and/or visit clinical areas must be a part of vetted and approved through established OHSU programs. See a list of approved programs.

CRISP (Clinical Research Investigative Studies Program)

The Clinical Research Investigative Studies Program (CRISP) exposes vetted pre-health students to the world of clinical research in emergency medicine through prospective ED research projects at the Marquam Hill campus. The CRISP program will give students considering potential health related careers hands on experience in the Emergency Department (ED) helping facilitate the completion of clinical research studies. The students will interact with both Emergency Department patients and research investigators. Since 2004, CRISP students have successfully screened, consented, and enrolled thousands of patients into multiples studies of varying complexity, including FDA drug and device trials, and cross-sectional and prospective survey studies.

Our CRISP students undergo hours of rigorous fundamental concepts of clinical research, confidentiality, consent and procedural skills, practice informed consent, continuous learning that provides ongoing research education including the CITI modules on Human Subjects Protection, GCPs, and HIPAA. Once trained, the CRISP student will use EPIC (the electronic health record system at OHSU) to proficiently screen all patients who come into the OHSU Emergency Department for each active study protocol.  If a patient is deemed eligible for the study, the CRISP student will inform the patient and/or the patient’s legal guardian (LAR) about the study, and proceed with the informed consent process if the patient is willing to participate.  Once the patient is consented, the CRISP students will move forward with enrollment procedures which can range clinical data abstractions, patient surveys, and/or work with the ED treatment team to collect necessary patient samples and imaging such as ECGs, blood, urine, or stool.

For more details, www.ohsu.edu/crisp  or view the CRISP information Flyer .

Commitment Requirements:

• Pre-health students, highly disciplined and motivated
• Able to commit to 2-four hour shifts (8 hours) per week for 12 weeks -then after 12 weeks able to commit to one-four hour (4 hour) shift per week – 1 year commitment
• Able to commit to 4h of mandatory office auditing shift

Eligibility :

• Pre-health students who can commit to the program for 1 year
• Excellent written and verbal communication skills
• Pre-health students who are highly motivated and detailed-oriented

Interested ? Please email [email protected] to get on the list. We will be hosting information sessions Quarterly throughout the year. To apply, www.ohsu.edu/applycrisp

Novel Interventions in Children’s Healthcare (NICH)

The Novel Interventions in Children’s Healthcare (NICH) program serves youth with a range of complex medical conditions and psychosocial vulnerabilities (e.g., insufficient access to resources, mental health issues, involvement with foster care system). The NICH research team, under direction of Drs. David Wagner and Michael Harris, is evaluating the ability of NICH to meet the triple healthcare aim: improving health, improving care, and reducing medical costs. Currently we are looking for research volunteers to help with a new study assessing risk factors of poor health outcomes in youth with type 1 diabetes who would be most likely to benefit from the program. This is a great educational and training opportunity for those interested in pursuing graduate study in psychology, social work, public health, pediatrics, emergency medicine, and related fields.

• Primary Duties: Research volunteers will primarily assist with participant recruitment, scheduling and tracking completion of study tasks, and medical chart review. There is also opportunity for volunteers to contribute to scientific posters and complete their own independent research project in a lab-related topic.
• Eligibility:  Must be a college junior, senior, or post bac. Must be comfortable interacting with individuals with diverse backgrounds in the hospital and community. Previous experience with adolescents and families, as well as access to reliable transportation, a plus, but not required.  
• Commitment:  Requesting a minimum commitment of 10 hours/week for 9-months.
• Interested?   Please send Kristen Torres ( [email protected] ) and Dr. David Wagner, PhD ( [email protected] ) a letter of interest, a resume and/or vita, and the names and contacts of 2 individuals who can provide professional references.

For more information about NICH, go to: https://www.ohsu.edu/xd/health/child-development-and-rehabilitation-center/clinics-and-programs/cdrc-portland-programs/nich/

OHSU Innovation and Commercialization Internship

The OHSU Innovation and Commercialization internship program is an educational experience for individuals interested in technology transfer, business development, and/or patent law. Get real-world experience assisting with innovation development and the transition of technology from laboratory to market. Eligible interns can receive a monthly stipend and/or academic credit for program participation. Please note that this program is primarily remote/virtual, but interns in the Portland metro area may have the opportunity for to attend some in-person meetings.

• Commitment: An average of 8 to 10 hours per week for at least six months time. Intern performance will be assessed every three months. The program length may be extended for interns in good standing, per a formal review process.
• Eligibility: Applicants must hold a bachelor's degree in a life science, a physical science, and/or engineering; be pursuing or have received a graduate-level degree in science, medicine, engineering, business, or law; and have an interest in intellectual property, technology transfer, and/or business development as a career goal.
• Interested? Please see the OHSU Innovation and Commercialization Internship Website for application instructions. Contact Nicole Garrison ( [email protected] ) with questions.

Oregon POLST Registry

The Oregon POLST Registry is a secure electronic record of patient’s end-of-life treatment preferences (POLST- Portable orders for life-sustaining treatment). The Registry relies on the hard work of our generous volunteers to process communication with POLST patients via mailed registration confirmation. Registry confirmation packets include a letter confirming the registrant’s information, medical orders, and other printed materials. The Registry also sends out notifications when a registrant updates their POLST orders and notifications for POLST forms that are about to expire. Volunteers will gain experience handling PHI, diversify knowledge of HIPAA compliance in a non-clinical setting, and support emergency services. The Registry team is truly grateful for the time and energy that volunteers contribute to the Registry’s mission.

• Primary Duties : Preparation of registrant confirmation packets, update letters, and 10 year expiration letters. Volunteers will additionally verify that the content of the mail is being sent to the correct person.
• Commitment : Between 2-4 hours a week for a minimum of 3 months.
• Eligibility : Volunteers must be at least 16 years old. The hours are flexible but must be completed within The Registry’s business hours – Monday through Thursday 7:30 to 4:00 PM.
• Interested? Contact: [email protected] for more information.

Pediatric Nephrology Department Volunteer

The Pediatric Nephrology Department is actively involved with many ongoing national clinical trials including longitudinal observation studies, rare diseases, pharmacokinetics, and investigator initiated research.

• Primary Duties: Volunteers will assist research coordinators with study visits, data collection, data entry, and other scholarly activities with opportunities for networking and participation in publications. We are recruiting volunteers who are enthusiastic about research and would like to gain experience in working with pediatric clinical trials.
• Eligibility: Completion of bachelor degree in science field is preferred but will consider exceptionally qualified applicants. Pre-medical students are encouraged to apply. Must be detail oriented, organized, timely, and professional. Basic knowledge of computer application software preferred.
• Commitment: 6-16 hours per week for least 6 months.
• Interested? Please e-mail Kira Clark at [email protected] with a CV and cover letter.

Prenatal Environment And Child Health (PEACH) Study

The Prenatal Environment And Child Health (PEACH) Study, under the direction of Dr. Elinor Sullivan and Dr. Joel Nigg are looking for volunteers to aid in their study. The PEACH Study is a longitudinal research study that will follow mothers from the second trimester of pregnancy until the child is 5 years of age. The purpose of this study is to learn more about how prenatal factors, such as nutrition, influence infant and toddler behavior and risk of neurodevelopmental disorders such as ADHD. This study will determine which prenatal factors are the strongest predictors of alterations in infant and toddler behavior associated with neurodevelopmental disorders, and set the stage for new approaches to prevent or treat child mental health problems.  

• Primary Duties : Volunteers may assist the lab with recruitment, eligibility screening, participant visits, data collection and scoring, data entry, cleaning of physiological data, coding of video taped visits, transcription of audio files and other general laboratory and administrative duties in support of the study. Specific responsibilities wi ll depend on each volunteer’s interests and strengths.  
• Com mitment : A minimum of 4 -15 hours p er week for at least 1 year.
• Eligibility : Must be a junior, senior or post bac (or have exceptional qualifications). Coursework in nutrition, infant and early life development, neurophysiology, and infant and child behavior is preferred/ beneficial. Preferred minimum G PA of 3.0. Must have some availability during the workday with the possibility of working over weekends. Must have strong interpersonal skills, be detail oriented, organized, timely , and professional. Experience working with infants and young children is preferred but not required . Previous experience of behavioral coding if preferred but not required . Basic knowledge of computer application software (SPSS, Excel) is preferred.  
• Interested? Please send your CV, your availability (days/times that you are available to volunteer) to [email protected] . If you have any questions, please contact Jessica Tipsord at [email protected] .  

Pulmonary and Critical Care & Sleep Medicine (PRISM)

PRISM research team performs phase II-IV clinical trials in pulmonary clinics and hospital settings. We have multiple ongoing clinical trials in conditions like pulmonary artery hypertension, COPD, and acute respiratory distress syndrome. We accept highly disciplined volunteers to conduct chart reviews of study subjects/patients using electronic medical records (EPIC) and enter the information in a secure database and support research coordinators. Our offices are located on the 1st floor of Emma Jones Hall, Room 121. Shadowing opportunities will be offered to our volunteers after completion of 6 months of volunteering with PRISM.

• Primary Duties : Conduct chart reviews of study subjects/patients using electronic medical records (EPIC) and enter the information in a secure database and support research coordinators.
• Commitment : Volunteers are expected to be available at least two half days (8 hours) a week for a period of 12 months.
• Eligibility : Intended for pre-medical students interested in gaining research experience before applying to medical school. International medical graduates interested in gaining experience in phase 2 and phase 3 clinical trials in pulmonary critical care and sleep medicine may also apply.
• Interested ? Contact: [email protected] with your resume, and a statement of interest/goals for PRISM.

For more information, visit the Division ( https://www.ohsu.edu/school-of-medicine/pulmonary-critical-care-medicine ) and the study team ( https://www.prismtrials.com/ ) websites.

Transgender Health Research InitiatiVE (THRIVE)

Intermittent research volunteer opportunities available for motivated graduate students or advanced undergraduate students interested in conducting research with transgender and gender diverse youth and their families. Example research projects include retrospective medical chart review, measurement development (e.g., gender euphoria measure), and quality improvement related to transition from pediatric to adult healthcare. The position would be directly supervised by Danielle Moyer, PhD, assistant professor in the OHSU Department of Pediatrics and Division of Psychology.

• Must have excellent interpersonal skills
• Comfortable working in a professional and clinical environment
• Strong writing skills
• Preferably detail oriented and organized
• Familiarity with psychology, medicine, or public health
• Prior experience with youth and/or the transgender community is a plus
• Lived experience or strong allyship preferred
• Commitment: Availability for volunteering for specific projects is subject to change, and specific volunteer duties and required hours will depend on the specific project and current project status. An individualized research training experience will be established based on availability as well as volunteer’s interests and goals. Publication opportunities and/or opportunities to observe clinical care may also be available. Please note that onboarding for non-OHSU affiliated volunteers may take up to 2 months, and therefore may not be a good fit for those looking for short-term experiences. Those affiliated with OHSU may also need additional onboarding.
• Contact Information:  To inquire about current opportunities, please email Dr. Danielle Moyer at [email protected] with a brief statement of interest, availability to volunteer, and any current affiliation with OHSU. If an appropriate opportunity is available, you will be asked to provide your CV/resume and a professional/academic reference. Feel free to email for any qualifying questions or to learn more.

VirtuOHSU Simulation & Surgical Training Center Volunteer

Pre-health (pre-nursing, pre-med, pre-PA, pre-pharmacy, etc.) undergraduate or graduate student volunteers are needed to assist the VirtuOHSU Simulation & Surgical Training Center, team in OHSU Simulation. OHSU Simulation is the health care simulation program at OHSU responsible for training a variety of health care providers in controlled and simulated environment, outside of the clinical setting. There are 3 major simulation centers on the OHSU, Portland, campus: VirtuOHSU Simulation & Surgical Training Center and Multnomah Pavilion Simulation on Marquam Hill as well as the Mark Richardson I Simulation Center in CLSB. This volunteer work would be up on Marquam Hill. 

• Primary Duties:  Duties include assisting with lab events, facilitating set up and break down of training sessions, maintenance of simulation models, administrative duties, organization of supplies, and assisting with the outreach events for surgical simulation. Volunteers work closely with medical students, residents, faculty, and OHSU Simulation Staff to accomplish the mission of OHSU Simulation. 
• Volunteer Schedule:  Flexible, Monday-Friday with variable hours between 0800-1700. Estimated 4-6 hours per week, no less than 2 hours for a day. 
• High School Diploma or equivalent 
• Must be at least 21 years of age for VirtuOHSU Simulation & Surgical Training Center 
• Must be able to show current enrollment as an undergraduate or graduate student 
• Must demonstrate excellence in verbal and written, communication, professionalism, motivation, reliability, organization, time management, and customer-service focus 
• Candidate should be able to work independently and as part of a team, effectively multi-task, be attentive to detail, and possess an aptitude for problem-solving 
• Individual must be able to lift and move 30 pounds easily as needed 
• The volunteer will be willing to work within the same lab space as animal and cadaveric tissues occasionally 
• Professional interest in medicine, health care, simulation, life sciences, and/or medical research 
• Course work in pre-health, pre-medicine or life sciences 
• Professional interest surgery (specifically for VirtuOHSU)  
• Experience in event planning 
• Interested?  Please email Cover Letter, resume, include current GPA, references, and letter of recommendation to: VirtuOHSU Simulation Center: Elena An, Operations Director OHSU Simulation at [email protected]  

Additional Details 

• Parking access on Marquam Hill/OHSU campus is extremely limited. Please be prepared to walk, bike, or use public transit to and from OHSU 
• See more information at http://www.ohsu.edu/xd/education/simulation-at-ohsu/ 
• It is expected that all volunteers dress in business casual attire (collared shirt, no jeans or shorts, no tennis shoes) or clean, well fit scrubs and closed toed shoes.  

Please note: In compliance with Oregon law, OHSU’s COVID-19 Immunization and Education policy will go in effect Oct. 18, 2021. Visitors and volunteers who have an in-person assignment must be fully vaccinated (defined as having received both doses of an original two-dose COVID-19 vaccine, or one dose of an original single-dose COVID-19 vaccine, and at least 14 days have passed since the individual's final dose of COVID-19 vaccine) or adhere to any requirements set forth by OHSU's Occupational Health Clinic for unvaccinated individuals.

Masks Strongly Recommended but Not Required in Maryland, Starting Immediately

Due to the downward trend in respiratory viruses in Maryland, masking is no longer required but remains strongly recommended in Johns Hopkins Medicine clinical locations in Maryland. Read more .

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Behavioral Pharmacology Research Unit

Research volunteer opportunities.

The Behavioral Pharmacology Research Unit has a number of opportunities to participate in clinical studies as a research volunteer. Eligibility requirements vary depending on the study but are generally open to both men and women at least 18 years of age. These research projects are currently looking for people who are:

Healthy Volunteers Needed for Paid Cannabis Research Studies

Volunteers currently maintained on methadone needed for research study, volunteers with opioid use disorder needed for research study, do you smoke tobacco cigarettes regularly, struggling with addiction cocaine and heroin users needed for research study.

• Cigarette Smokers Needed for Study on Stress and Breathing in Smokers
• Cigarette Smokers Needed for Study on Smoking Behavior  

Oxytocin and Decision-Making Research Study

Quit smoking before bariatric surgery.

• Cigarette smokers wanting to quit

Help Us Learn Why Drugs Affect People Differently

Healthy volunteers needed for research study at johns hopkins bayview.

Healthy volunteers are needed to take part in four Johns Hopkins research studies involving cannabis, one of which involves tobacco and cannabis. Principal investigator for all the studies is Ryan Vandrey, Ph.D. Brief descriptions of the studies, the amount of compensation, and contact phone numbers follow:

• People age 18–55 who are current tobacco users and have a history of occasionally using cannabis (marijuana). Participants will be paid up to $1,730 for study completion. Study involves smoking cannabis and also smoking a tobacco cigarette or vaping with an e-cigarette over seven experimental sessions. Call 410-550-0050 for more information. Protocol #: IRB00220975. 
• Volunteers age 18–55 who have a history of occasionally using cannabis (marijuana). Participants will be paid up to $3,230 for study completion. Study involves vaping substances found in cannabis (such as THC) in nine separate experimental sessions, each lasting about seven hours. There is also a separate screening visit lasting about three hours to determine eligibility. Call 410-550-0586 for more information. Protocol #: IRB00182689. 

Are you currently maintained on methadone? Are you interested in participating in a research study about a new medication to treat withdrawal? This clinical research study at the Johns Hopkins Bayview Campus involves two 3-day/2-night overnight visits during which you will not take your methadone dose. The goal of the study is to determine whether Cannabidiol (CBD) reduces opioid withdrawal. You must be maintained on methadone and be 18-55 years of age to participate. Participation requires two overnight stays - 3 days each (2 nights); Duration of the study is about 3 weeks; Compensation up to $1130 may be provided. Call (410) 989-1756. PI: Kelly Dunn, Ph.D. Protocol # IRB00232412

Are you physically dependent on opioids? Do you have symptoms when you try to stop using? This clinical research study at the Johns Hopkins Bayview Campus involves supervised opioid withdrawal in a residential setting. The goal of the study is to examine an FDA-cleared medical device that might lessen the symptoms of opioid withdrawal. You must have opioid use disorder and be 18 to 65 years old to participate. Participation requires an inpatient stay of 16-20 days. Duration of the study is about 3 weeks. Compensation up to and between $1230 and $1530 may be provided. Call (410) 989- 1756. PI: Eric Strain, M.D. Protocol # IRB00241133

Cigarettes smokers age 21-50 are needed for a paid research study that includes a screening visit, three study visits with a practice quit attempt, and brain imaging. Participants will be paid up to $645 for study completion. To learn more, visit  https://jhmi.co1.qualtrics.com/jfe/form/SV_0wGrqvxIxt3Nl9H  or call 410-550-1102, Behavioral Pharmacology Research Unit, Johns Hopkins Bayview Medical Center, Principal Investigator: Elise M. Weerts, PhD, Protocol #: IRB00173536

Are you physically dependent on opioids? Do you have symptoms when you try to stop using? This clinical research study at the Johns Hopkins Bayview Campus involves supervised opioid withdrawal in a residential setting. The goal of the study is to examine a sleep medication that might lessen the symptoms of opioid withdrawal. You must have opioid use disorder and be 18 or older to participate. Participation requires an inpatient stay of 11 days (10 nights) and 1 follow-up visit. Duration of the study is about 3 weeks. Compensation up to $1460 may be provided. Call 410-550-1206. PI: Andrew Huhn, Ph.D. Protocol #IRB00198426. Download flyer.

If you have a history of cocaine and heroin use you may qualify for a 30-week research study. You must be interested in methadone treatment, or already enrolled in methadone treatment to be eligible. You can earn up to $900 for study participation. Scheduling is flexible, screening is confidential, and you will be compensated for your time. For more information, please call 410-336-7762. Principal Investigator: Kelly Dunn, Ph.D. (Protocol # NA_00090062). Download flyer.

Cigarette Smokers Needed for Study on Stress and Breathing in Smokers

Attention healthy cigarette smokers. Johns Hopkins Bayview Medical Center (JHBMC) is currently recruiting adult cigarette smokers ages 18 to 65 for a research study. The 2-3 weeks study, requires 3 visits to JHBMC to evaluate the relationship between stress and breathing in smokers. Scheduling is flexible and you will be compensated for your time. If you are interested call us at 410-550-2799 or click the link below for details. Refer to study 1609. All calls are confidential. PI: Annie Umbricht, M.D. Study #: IRB00031600. Download flyer 

Cigarette Smokers Needed for Study on Smoking Behavior

You will be paid up to $2760 for completing the entire study. Healthy men and women who smoke cigarettes and are 18 years old or older are needed to participate in a research study at the Johns Hopkins Bayview Medical Center. This is not a treatment study. The study tests factors that influence smoking behavior. Participation involves an initial phone screening and an in person 3 hour screening visit. If qualified, this study requires an additional 32 in person visits lasting approximately 4 hours each, and 4 in person visits lasting approximately 1.5 hours each. Morning, afternoon, and evening times are available for in person visits. For more information, please call (410) 550-1465. Principal Investigator: Matthew Johnson, Ph.D. (Protocol #: IRB007178). Download flyer

Healthy men and women 18 years of age and older are needed to participate in a research study at the Johns Hopkins Bayview Medical Center. This is not a treatment study. The study tests whether oxytocin can influence decisions and other types of thinking. Participation involves an initial phone screening, and an initial in person screening visit. If qualified, 2 sessions each lasting roughly 3 hours will occur. You will be paid up to $250 for completing the entire study. For more information, please call (410) 550-1465. Principal Investigator: Matthew Johnson, Ph.D.  (Protocol #: IRB00133379) Download flyer

Are you a cigarette smoker who is scheduled to have  bariatric  surgery? Did you know that smoking before and after surgery significantly increases your chance for health complications from your surgery? Researchers at the Johns Hopkins Bayview Medical Campus are conducting a 12-week research study to help you quit smoking. The study will provide access to FDA approved smoking cessation medication and counseling to help you stop smoking before your surgery and to stay quit even after surgery. The study requires once weekly visits for 12- weeks, and you can earn up to $950 for your time. All information is kept confidential. Please contact us for more information or to see if you may be eligible at 410-550-9497 or  click this link  to complete a brief survey and see whether you may be eligible!  Principal Investigator:  Kelly Dunn, Ph.D.  (Study Number: IRB00071969)

Cigarette Smokers Wanting to Quit

Johns Hopkins University School of Medicine is seeking cigarette smokers who would like to quit smoking for participation in a scientific research study. The study involves free counseling and treatment provided in a comfortable, supportive setting. Transdermal nicotine patches, an FDA approved smoking cessation treatment, may be provided in the study. Cognitive behavior therapy and ongoing interpersonal support will be provided in order to help volunteers quit smoking. Questionnaires, interviews, MRI scans, and biological measures of smoking will be used to assess the treatment’s effects on mood, and smoking. Volunteers must be right handed, must be between the ages of 21 and 65, and must live within travel distance of the Hopkins Bayview campus in Baltimore. If you would like to discuss the possibility of volunteering, please call 410–550–1972 and ask for Albert, the study’s research coordinator or go to http://www.quitsmokingbaltimore.org  . Confidentiality will be maintained for all applicants and participants. Principal Investigator: Matthew W. Johnson, Ph.D. , (Study Number: NA_00016166) Download Flyer

Researchers at Johns Hopkins are conducting a study to learn more about why medications may affect people differently. Healthy men and women between 21 and 50 years of age who are willing to live at Johns Hopkins Bayview Medical Center for five days may be eligible, and will be compensated up to $750 for their time. Call 410-550-9799 for more information and to learn whether you may be eligible. See if you qualify here  https://tinyurl.com/1403-SeekingHealthyVolunteers ​.  Principal Investigator: Kelly Dunn, Ph.D . (Study Number: NA_00047423) Download Flyer

Johns Hopkins University School of Medicine researchers are seeking healthy volunteers ages 18-65 to participate in a research study of the effects of commonly used medications on mood and medication preference. This study requires brief visits to our Bayview campus on weekdays. Participants may earn up to $2000. To learn more or see if you may be eligible, please email [email protected] or call (410) 550-1927. See if you qualify here.    Principal Investigator:  Roland R. Griffiths, Ph.D.  Protocol: IRB00165287.  Download flyer.

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Medical Research Volunteer Program (MRVP): innovative program promoting undergraduate research in the medical field

Michael m. dagher.

Department of Psychology, American University of Beirut, Beirut, 1107-2020 Lebanon

Jessica A. Atieh

Department of Biology, American University of Beirut, Beirut, 1107-2020 Lebanon

Marwa K. Soubra

Department of IT Academic Core Processes & Systems, American University of Beirut, Beirut, 1107-2020 Lebanon

Samia J. Khoury

Abu Haidar Neuroscience Institute, American University of Beirut, Beirut, 1107-2020 Lebanon

Department of Internal Medicine, American University of Beirut, Beirut, 1107-2020 Lebanon

Bilal R. Kaafarani

Department of Chemistry, American University of Beirut, Beirut, 1107-2020 Lebanon

Associated Data

Data are accessible by contacting the corresponding authors.

Most educational institutions lack a structured system that provides undergraduate students with research exposure in the medical field. The objective of this paper is to describe the structure of the Medical Research Volunteer Program (MRVP) which was established at the American University of Beirut, Lebanon, as well as to assess the success of the program.

The MRVP is a program that targets undergraduate students interested in becoming involved in the medical research field early on in their academic career. It provides students with an active experience and the opportunity to learn from and support physicians, clinical researchers, basic science researchers and other health professionals. Through this program, students are assigned to researchers and become part of a research team where they observe and aid on a volunteer basis. This paper presents the MRVP’s four major pillars: the students, the faculty members, the MRVP committee, and the online portal. Moreover, details of the MRVP process are provided. The success of the program was assessed by carrying out analyses using information gathered from the MRVP participants (both students and faculty). Satisfaction with the program was assessed using a set of questions rated on a Likert scale, ranging from 1 (lowest satisfaction) to 5 (highest satisfaction).

A total of 211 students applied to the program with a total of 164 matches being completed. Since the beginning of the program, three students have each co-authored a publication in peer-reviewed journals with their respective faculty members. The majority of the students rated the program positively. Of the total number of students who completed the program period, 35.1 % rated the effectiveness of the program with a 5, 54.8 % rated 4, and 8.6 % rated 3. A small number of students gave lower ratings of 2 and 1 (1.1 % and 0.4 %, respectively).

The MRVP is a program that provides undergraduate students with the opportunity to learn about research firsthand as they volunteer and aid in different research projects. This program also provides faculty members with the help to conduct their research projects and opportunity to influence future generations. It was shown that so far the MRVP has been successful in reaching its goals, for both students and faculty.

Research is an integral part of science that develops not only the field itself, but also the researcher. Without it, there could be no progress. As such an important part of the field, it comes as a surprise to find that its value is not better highlighted during students’ undergraduate education. Research is a process that must be mastered to ensure the continuity of any science. It follows that students should be exposed to research as soon as possible, providing them with enough time to become truly proficient [ 20 ]. Research exposure at such an early academic level serves more than just to engender an interest in research. Several studies have shown an increase in student interest and involvement in their academic field after exposure to research [ 7 , 10 , 11 ]. It also provides them with a platform from which to begin their professional socialization [ 6 , 14 , 15 ]. Research exposure also serves as a means by which to clarify a specific career path [ 6 , 8 , 17 , 18 ]. Students, who engaged in research, reported increased development of their critical thinking [ 3 , 16 , 21 ], specific research skills [ 3 , 5 ], communication [ 6 , 9 , 13 , 20 ], self-confidence in their abilities [ 3 , 7 , 17 ] and sense of self-efficacy [ 1 , 4 , 19 ]. Research also provides the student with the chance to move beyond simple textbook learning and to learn in a more hands-on environment. This experience greatly enriches the education of these individuals.

Exposing undergraduate students to research not only benefits them but also the faculty and researchers who provide this exposure [ 21 ]. By working with undergraduate students, faculty members get the chance to refine and shape the scientific minds of the future. In fact, this is often listed as one of the top motivating factors for faculty to invest in students and their education [ 20 ]. Another highly prominent benefit to the researchers themselves is the added input and contribution that the students bring to the research project. As expected, the longer a student can contribute to a project, the more meaningful the contribution can become. As such, many faculty members encourage research exposure from as early on as Freshman year [ 21 ].

Although all the aforementioned benefits apply to all students, it holds true for undergraduates interested in pursuing a career in the medical sciences more than most. With the dominant wave of evidence-based learning and practice in the medical field, the ability to understand and appreciate research is crucial. Research exposure in the medical field provides students with vital skills such as the ability to understand, interpret and evaluate evidence, research methodology and medical experimental results. These skills allow undergraduates to become active members of the professional medical research community and not just passive spectators.

Most educational institutions lack a structured system that provides students with this highly valuable research exposure in the medical field. This lack constitutes a major shortcoming of the undergraduate education leading up to the medical profession. This paper details a solution to this limitation: the Medical Research Volunteer Program (MRVP). This program aims to systematically and reliably provide research experience to undergraduate students interested in entering the field of medicine. The primary objective of this paper is to describe the structure and function of the MRVP and to promote and facilitate its replication in other universities around the world. Moreover, the secondary objective is to assess the success of the program by analyzing data about participation and satisfaction with the program.

Following is the description of the methodology followed for each of the two primary and secondary objectives of this paper.

Primary objective

The MRVP is a program that targets undergraduate students interested in becoming involved in the field of medical research early on in their academic career. It provides these students with an active experience and the opportunity to learn from and support physicians, clinical researchers, basic science researchers and other health professionals. Through this program, students are assigned to researchers and become part of a research team where they observe and aid on a volunteer basis. For many students, the MRVP will provide their first exposure to the field of research. As students help in the various tasks assigned to them, they will witness first-hand the extensive work that goes into scientific research.

The MRVP was established at the American University of Beirut (AUB) in Lebanon. AUB is one of the leading universities in the region, founded in 1866. AUB has a diverse population of students. There are 8712 students enrolled at AUB (September 2015). Almost one quarter of these students are internationals.

The stages of the MRVP development

The MRVP has passed through three major stages as it developed. Each of these stages is described below.

• The Dormant Phase

The dormant phase of the MRVP was initiated in the Fall of 2013 by one of the authors. It entailed matching students who showed outstanding potential to faculty members who were willing to welcome undergraduate student volunteers into their research teams. Although at the time there was no structured program guiding these matchings, this phase served as a major stepping stone for the program.

• b. The Pilot Study

Following the successful experience of the dormant phase, the pilot phase was conducted by the authors of this paper during the summer of 2014. It entailed the development of the program’s guidelines and procedures. It was in this phase that both the MRVP website and the accompanying portal were developed. The pilot study marked the official inauguration of the MRVP.

• c. The Current Stage

After the base of the MRVP had been firmly established, the current phase of the program began in the Fall semester of 2014. This program relies on four major pillars: the students, the faculty members, the MRVP committee, and the online portal. The following four sections provide more details about each of the four pillars.

The MRVP is open to undergraduate students at AUB who are interested in pursuing a career in the medical field. This is not a program that can cater to the needs of all students. As such, certain inclusion criteria were developed.

One criterion for admission to the MRVP is that the student must be interested in medical research and willing to commit to the requirements of the program. Students from a variety of majors (Biology, Chemistry, Chemical Engineering, Environmental Health, Medical Lab Technology, Nutrition, and Physics) are eligible to apply. In addition, all premedical students, regardless of major, are eligible to join the MRVP. All applicants must have completed a minimum of 24 credits at the sophomore level and have a cumulative average of 78 % or above. Finally, the applicants must provide at least 8 h/week.

Students’ cooperation and adherence to the instructions given to them is vital to the success of the program. Although each research project is governed by its own specific set of rules based on the nature of the research, there are certain guidelines that every student participating in the MRVP should follow. Upon starting work on a research project, students are expected to contribute to the best of their ability in a committed and ethical manner.

All faculty members in the Faculty of Medicine with professorial rank and active ongoing research projects are eligible to participate in the MRVP. The faculty members take the role of mentors to the students and facilitate the students’ learning process by providing supervision, guidance, and support. As such, participating faculty members must have sufficient time to invest in the program. In addition, members should allocate suitable tasks for each student based on their skills, expertise, interests, and background.

The MRVP is headed by a committee that is responsible for overseeing the program. The committee is composed of a combination of faculty members (from both the undergraduate level and the Faculty of Medicine) and student representatives. The roles of the MRVP committee include, overseeing the process and ensuring the success of the program, recruiting students and faculty members to the program and matching students and faculty members based on interests and needs of both. The committee is also responsible for following up on the students’ progress in their volunteer work, resolving any arising conflicts throughout the process and continuously evaluating and developing the program.

Developed in coordination with the Information Technology (IT) department at AUB, the portal is an online program that aids in the compilation of the needed data and facilitates the management of this data. It provides an efficient way for both faculty and students to provide their information. The portal grants the MRVP committee access to this information and allows it to be easily managed and manipulated during matching.

The MRVP process

The MRVP process includes the following steps.

• Student Orientation

The MRVP committee holds a 2 h student orientation before the beginning of each MRVP call. Any student may attend this orientation session although the target audience is primarily those students who have successfully fulfilled all the inclusion criteria previously discussed. It serves to inform students of the program’s procedure and their roles and responsibilities. This orientation also serves to dispel any misconceptions about the program and provides students with an open floor where their questions and concerns can be addressed. Students are also provided with important dates and deadlines for the MRVP. The orientation also serves to teach the students how to interact with the online portal. A live demonstration is included to ensure that all the functions of the portal are explored.

• 2. Student Application

The next step of the process is to collect enough information about the student to understand what type of research he/she is looking for and what role they wish to play. The application form gathers basic personal information as well as information about applicants’ academic records, research experiences, research interests, and time availability. The data gathered through the applications are used to construct a regularly updated database of student profiles allowing students to be promptly assigned to the right research projects. Students apply to the program by creating an online profile that contains all the required information. Applications are time restricted so students only have access to this function at specific predetermined times.

• 3. Faculty Information

Faculty members are prompted to fill out an online form by a mass email and announcements on the institution’s website. This form collects information including contact information such as specialty, current research projects as well as the number of students they are willing to work with and any specific background requirements they wish these students to have. Some faculty members may have more than one active project at any given time and some projects can accommodate more than one student volunteer. Similar to students, each faculty member also provides this information via the generation of an online profile on the portal. This information is also compiled into a database.

• 4. Matching

Matching is the process through which students get paired with projects. Using the information available in the compiled database, the portal generates suggestions of potential student-project matches based on different factors, mainly: research interests, number of proposed interests, availability of projects, as well as time of student’s profile creation. Students are prioritized on a first-come-first-served basis. The portal also assigns alternative matches: cases in which students are available but their research interests are different than the ones needed. The system does not automatically match the students to the projects, it only suggests potential and alternative matching. The matching must be made by members of the MRVP committee via the portal. Both the students and researchers are informed of the details of the match, via an automated email notification. Matching is completed in a timely manner, usually within two days after the application deadline. In this way, students can begin their MRVP experience with a minimal wait between applying and getting matched.

• 5. Work Initiation

Students are expected to initiate contact with the faculty member after being notified via email that they have been matched to a project. Faculty members and students must discuss the research project and the roles and responsibilities which will be delegated to them. Upon finalizing the agreement between the two parties, the student is required to fill out the “MRVP Initiation” form on the portal. This form includes information about the study and the terms of the volunteer work such as the number of hours of work per week and the role of the student in the research project.

• 6. Follow-Up

A “Follow-up” form is submitted, via the portal, to the MRVP office every two months. These reports give the students a platform to voice their suggestions, comments and complaints as well as the chance to inform the committee of what responsibilities have been allocated to them. The report serves to document what students have been doing and the challenges they are facing. It is also used to inform the MRVP committee of any modifications to the initial agreement between the student and the faculty member. This form contains both open-ended and Likert-type questions that aim to assess the satisfaction of the participating students.

• 7. End of Agreement

Students are required to submit a “Student End of Volunteering” form when they finish their volunteer work. This form is a more detailed version of the reports that students have been submitting to the MRVP office bimonthly. The “Student End of Volunteering” form evaluates both the student’s personal experience and the MRVP in general. Although faculty members are not required to submit a “Follow up” form every two months, they are asked to submit a “Faculty End of Volunteering” form at the end of each student’s volunteering period. This gives the researcher an opportunity to evaluate both the student’s performance and the MRVP in general.

• 8. Evaluation and updating the program

The data from the “Follow-Up” and “End of Agreement” forms are used to assess the success of the program after each MRVP call. Any issues that are brought to the committee’s attention through the feedback are addressed before the beginning of the next MRVP call. In addition, the committee continuously evaluates the program in an attempt to enhance and refine it.

Secondary objective

To address the second objective about the outcome of the program, a sub-study was carried out to assess student and faculty participation as well as their evaluation of and satisfaction with the MRVP. Data was collected from the portal for students who joined between the summer of 2014 and the summer of 2015 (all stages of the program excluding the dormant phase). Data from the dormant phase was not included as it was a preparatory stage that was used to develop the program. The data collected fell into two main categories of information: student and faculty. Student information included basic demographics, major, application rates, dropout rates and satisfaction with the program. For the faculty, the information collected was limited to the number of participating researchers and the number of projects each researcher was currently accepting students on. The data was analyzed by generating and comparing means. Trends across calls were also analyzed and interpreted.

Data collection and measures

Data was collected from both students and faculty members. For students, this information included total number of student applicants and demographics such as gender, major, date of enrollment in the MRVP, and academic year at the time of initial registration. This data was collected from the student profiles found on the MRVP portal. For faculty members, information including total number of faculty profiles and projects was also extracted from the MRVP portal. To measure satisfaction, the “Follow-Up” and “End of Volunteering” forms were used. The “Follow-Up” form, administered to students, contains six questions measured on a 5-point Likert scale to assess satisfaction with the program in general. Similarly, seven questions of similar format assessed the students’ satisfaction with the project they had been matched to. Two open-ended questions allowed the students to summarize the role they had played in the research team and allowed them to voice any additional comments. A final question asked students to rate their overall satisfaction with the program on a five-point Likert scale. The student version of the “End of Agreement” form is comparable to the “Follow-Up” form. Data was collected from the faculty members using the faculty “End of Volunteering” form. This form includes seven questions assessing the researchers’ satisfaction with the program and nine questions assessing their satisfaction with the student volunteer. All these questions are measured on a five-point Likert scale. Open ended questions allow the researchers to voice any additional comments.

Data analysis

The data collected from the portal and various forms were analyzed using IBM’s Statistical Package for the Social Sciences (SPSS) version 22.0 (IBM, Inc, Chicago, IL). The data was summarized by generating numbers and percentages. Trends were assessed across time.

Table  1 summarizes the characteristics of the volunteers who were involved in the MRVP. A total of 211 students applied to the program, with more than half of the applicants being female (55.5 %). The highest number of applicants was in the Summer 2014 call ( N =  83), while the lowest was in the Summer 2015 call ( N =  36). The vast majority of the applicants were from the Faculty of Arts and Sciences (82.9 %), followed by the Faculty of Health Sciences (13.7 %), and the minority were from the Faculty of Engineering and Architecture (0.5 %) and Hariri School of Nursing (0.5 %). Within the Faculty of Arts and Sciences, Biology (78.9 %) and Chemistry (12.0 %) students comprised most of the applicants, while Philosophy (0.6 %) students were the least. Regarding the class breakdown, application rates were the highest for juniors (50.7 %) and lowest for sophomores (19.8 %).

Characteristics of volunteers who were involved in the MRVP

a The data found in this subsection under “Number of Students Applied” include those who have applied to more than one call. The total number of students in this subsection is thus greater than 211, the total number of students who applied to the program

The number of matches within each call since the beginning of the MRVP is also presented in Table  1 . A total of 164 matches have been completed. There appears to be no significant difference between the numbers of female (48.2 %) and male (51.8 %) students matched. The highest number of matched students was in the Summer 2014 call (45.7 %), while the lowest was in the Fall 2014–2015 call (15.9 %). Similar to the application rates, the Faculty of Arts and Sciences (86.0 %) has the highest matching rate among the faculties, and Biology (83.0 %) has the highest matching rate among the majors within its faculty. The rates of students matched with respect to class is similar to the rates of students applied.

More than half of the students successfully completed the volunteering period in each call (Table  1 ). Of the total 60 dropped students, the highest was in the Summer 2014 call (50.0 %), followed by Summer 2015 call (20.0 %), and Fall and Spring 2014–2015 calls (15.0 %). The student dropout rates for males (53.3 %) are higher than those for females (46.7 %). With regard to faculty, the majority of dropped students are in the Faculty of Arts and Sciences (83.3 %), of which most are Biology students (88.0 %). In addition, juniors (51.7 %) experienced the highest rates of dropped students, with the lowest rates belonging to sophomores (8.3 %).

Table  2 provides the numbers of registered faculty members and projects in each call. A total of 102 projects were registered in the MRVP. 48.0 % of projects were registered in the Summer 2014 call, 16.7 % in the Fall 2014–2015 call, 20.6 % in the Spring 2014–2015 call, and 14.7 % in the Summer 2015 call. Regarding the faculty member registration, 49.3 % were registered in the Summer 2014 call, 16.0 % in the Fall 2014–2015 call, 22.7 % in the Spring 2014–2015 call, and 12.0 % in the Summer 2015 call, amounting to a total of 75 faculty member registrations. Since the beginning of the dormant phase of the MRVP, three students have each co-authored a publication in peer-reviewed journals with their respective faculty members.

Number of projects and faculty members registered in each MRVP call a

a Each registered project can continue over more than one call. The numbers of projects and faculty members displayed under each call may include both newly registered and continuing ones from previous calls

Response to the “End of Volunteering” form

Figure  1 illustrates the ratings of the effectiveness of the program as reported by the students. The majority of the students provided positive responses and high ratings throughout all the calls. Of the total number of students who completed the program period, 35.1 % rated the effectiveness of the program with a 5, 54.8 % rated 4, and 8.6 % rated 3. A small number of students gave lower ratings of 2 and 1 (1.1 % and 0.4 %, respectively). In the Summer 2014 call, the “End of Volunteering” form was filled out by 63 students, yielding a response rate of 94.0 %. The results showed that 46.0 % of students rated the effectiveness of MRVP with a 5, 49.2 % rated 4, 3.2 % rated 3, and only 1.6 % rated 1. In the Fall 2014–2015 call, none of the students rated the effectiveness of the program with 2 and 1. The response rate was 100.0 %. Twenty-three percent of students rated 5, 58.8 % rated 4, while only 17.6 % rated 3. The overall response rate of the Spring 2014–2015 call was also 100.0 %. More than a third (39.1 %) rated 5, 52.2 % rated 4, and 4.4 % rated 3. Only 4.3 % responded with a 2. Similar positive responses were reported in the Summer 2015 call. Of the total number of students who completed the volunteering period, 66.7 % ( N  = 22) filled out the “End of Volunteering” form, where 31.8 % rated the effectiveness of the program with a 5, 59.1 % rated 4, and 9.1 % rated 3.

Percentage of the student responses to the question about the effectiveness of the MRVP, with 1 being not effective at all and 5 being extremely effective.*

Figure  2 portrays the faculty member response rates concerning the effectiveness of the MRVP. In the Fall 2014–2015 call, the “End of Volunteering” form was filled by seven faculty members, yielding a response rate of 58.3 %. 13.3 % of the respondents rated the effectiveness with a 5, 60.0 % rated 4, and 26.7 % rated 3. The response rate of the subsequent spring semester (58.8 %) was comparable to that of the Fall 2014–2015 call. However, more positive responses were reported, with 40.0 % responding with a 5, 40.0 % responding with a 4, and 20.0 % responding with a 3.

Percentage of the faculty responses to the question about the effectiveness of the MRVP, with 1 being not effective at all and 5 being extremely effective.*

The MRVP is a program that provides to many undergraduate students their first exposure to medical research. Since its launch, the program has directed four calls and matched hundreds of students to projects in need of volunteers. The development of the portal is one of the MRVP’s many milestones that helped the program meet its goals and objectives. The progress and support of the program are dependent on its constant evaluation.

The MRVP was designed to serve the needs of both students and faculty members. Undergraduate students require proper exposure to research and mentorship in the medical field. On the other hand, faculty members require access to a constant supply of assistance to aid them in their research projects. Thus, the MRVP is a program that mutually benefits both parties.

For students, the MRVP provides them with an environment in which they will learn a subject matter in-depth from a hands-on experience and build long-term connections with physicians and researchers. By providing opportunities to participate in every phase of research, the MRVP allows students to learn how to apply scientific methodology and techniques, acquire laboratory skills and improve social skills such as teamwork and oral communication, and strengthen academic credentials. A recent study conducted in 2010 supports the aforementioned based on interviews with students who have engaged in undergraduate research in liberal colleges [ 12 ]. Laursen et al. found that the students who participated in research reported gains that can be grouped into six categories: “Personal/professional gains; Gains in thinking and working like a scientist; Gains in becoming a scientist; Gains of skills; Enhanced preparation for career and graduate school; and Clarification, conformation, and refinement of career and educational goals and interests”.

The MRVP is a signature program that provides more than just research opportunities for undergraduates. The program views research as the exploration of the unknown, whether in scientific or in personal terms. Decisions in the scientific community are as important as decisions taken in a career pursuit. Along with academic excellence, a career in the medical field requires life-long commitment and dedication to achieve success. A recent literature review has shown that completing undergraduate research programs may impact the student’s choice of future occupation [ 2 ]. Yet, many students follow a career path based largely on academic requirements and minute work experience. The MRVP realizes this lack of experience and works to foster intellectual maturity necessary for career decisions.

Faculty members participating in the MRVP are prestigious physicians whose projects reflect the type of work found in medical research. The MRVP emphasizes the significance of working with physicians at an early stage, allowing undergraduates to capture the reality of the work and dispel any misconceptions about this specific career path. The MRVP also allows students to contact faculty members in our committee for advice on academic and professional pursuits. In addition, a recent review on scholarly activity programs revealed that the students’ work in such programs influences their choice in career paths and interest in research [ 2 ]. The program thus highly values the discovery of oneself and works to initiate it at an early stage.

For faculty members, the MRVP provides a constant access to a wide pool of interested students willing to participate and contribute to research projects. It also provides faculty members with the opportunity to impact the minds of future generations by helping talented young students grow professionally and academically. Zydney et al. [ 21 ] conducted a study on faculty perception of undergraduate research at the University of Delaware. Results of surveys filled by faculty members showed that 75 % of the respondents perceive their desire to influence young students’ careers to be “important” or “very important” [ 20 ]. In addition, an undergraduate student’s fresh point of view can sometimes influence the faculty member’s thinking about the research project. Faculty members have an opportunity to communicate their subject with joy and passion, and, in the long-run, entice new students to their fields.

Finally, the MRVP is a program that aims to improve the overall quality of life at AUB and Lebanon. It contributes to the development of the research culture and promotes an interactive scientific community at AUB by inspiring passion for research in young talented minds. The program also helps researchers to be more productive in their research by providing support. This will ultimately translate into an increase in the productivity and impact of research conducted locally and nationally.

The gender demographics presented in Table  1 show the female to male ratio of students applied to the MRVP to be higher than that of the student population in AUB (1 male:1 female). A significantly higher percentage of male students dropped out of MRVP is also depicted. No previous studies have been found to explain such differences in gender demographics in terms of undergraduate research participation.

A decrease in the number of participating students during the calls following the pilot study is also evident in Table  1 . The decrease may reflect the increased difficulty of working on a research project in addition to maintaining high academic performance during the semester. Moreover, after registering for their first call, many volunteers matched with faculty members resume working during the following calls without updating their profiles on the portal, resulting in false negatives. In addition, due to their little experience in conducting research, some volunteers are not clear about what research is. A common misconception held by many students, especially school-leaver entrants, is that medical research always occurs in a lab. The faulty equation of research to lab work has led many students to express dissatisfaction when matched to a project that requires data analysis, proposal writing or manuscript writing. Though dissatisfied, the program evidently served one of its purposes of reflecting to students the possible tedious nature of research projects.

The aforementioned reasons may also explain the student drop out incidence in every call. Table  1 shows no significant difference in the number of students dropped among the calls, as the number dropped is proportional to the number matched in every call. In any case, the high number of students dropping out or disappearing from the program has proved to be a pressing challenge. It generates a decreased tendency of faculty members to participate in the MRVP and ask for more student volunteers in the future, as depicted by the decrease in number of faculty members and projects in Table  2 .

The results in Table  1 also show the Biology and Chemistry undergraduates comprising the highest percentages of students applied and matched. These high proportions are comparable to those of Biology and Chemistry pre-medical students at AUB. In addition, junior students constitute the highest number of profiles registered on the portal (Table  1 ). This may suggest that most students who are interested in the program are those who have found stability in their major and wish to gain better perspective on their academic or professional pursuit.

Like any novel program, it is crucial to objectively assess the success of the MRVP. Since the program is still in its early stages, measuring success in terms of publications will be unreliable. In addition, using the number of participating students and faculty members as a measure has shown to be defective due to false negatives. Our outcome measure is thus the feedback provided by both participating students and faculty. As illustrated by Figs.  1 and ​ and2, 2 , the majority of responses provided by students and faculty are positive, which reflect the success and utility of the program.

The MRVP has faced several challenges, mainly developing, maintaining and upgrading the portal, as well as sustaining students and faculty commitment. At the early stage of the portal development, difficulties arose in managing the students’ profiles and projects opened by faculty members. Challenges that affected the follow-up process of the program included the inability to manually match students and manage the status of faculty members’ projects, the inability to insert comments to student profiles, and the difficulty in culminating results to establish a report. Nonetheless, functionalities and features were added to incrementally adapt to the program maturity and to users’ requirements. Committee members now have access to override the portal and manually match projects and manage the status of the projects. In addition, a reporting tab was added to increase the feasibility of reviewing the results of each call and developing reports.

As for sustaining the students and faculty commitment, it has been a challenge throughout all calls. To address the students’ misconception of what research work entails, a student orientation lecture is held as of the 2015 Fall semester. During the first orientation session, which was organized at the beginning of the 2015 Fall semester, an overview of the program and the application procedure was presented. The wide range of research processes were explained to present a clear idea to the interested volunteers what to expect when entering the field of research. In addition, as of the 2015 Fall semester, the Fall and Spring calls have been merged to increase student commitment to the assigned project and program and thus encourage faculty members to recruit students. The extended work period will also provide students with a better chance to publish their findings.

Other challenges included the low response rate of filling out the “Follow Up” forms by the students, which affected the committee’s ability to monitor the progress of each student after the matching process. Moreover, faculty members have reported accountability issues where students are underperforming in the program due to other priorities such as academic responsibilities. To overcome these challenges, the importance of this step is highlighted during the orientation session. In addition, a system of closer follow up with the students is being implemented. Finally, another challenge is the lack of sufficient projects and faculty members registered in the program, which results in a number of unmatched applicants in almost every call. This challenge is expected to be resolved by merging the Fall and Spring semesters in one call, as previously discussed.

To further foster student commitment and promote educational innovation, the “Ibrahim and Loulu Durr Endowed MRVP Award” was established in May 2015. The $1000 award will be granted annually as of 2016 to an AUB Biology or Chemistry student enrolled in the MRVP, as per the wish of the donors. Based on the MRVP committee evaluation, the student awardee must “demonstrate outstanding medical research capabilities particularly in the biochemistry field”.

Conclusions

The MRVP is a program that provides undergraduate students with the opportunity to learn about research firsthand as they volunteer and aid in different research projects. This program also provides faculty members with the help to conduct their research projects and opportunity to influence future generations. The progress of the MRVP has so far proved to be dynamic, and we anticipate more changes to improve the program’s features and functionalities and to overcome the challenges faced. Discovering one’s career direction at an early stage is one of the program’s main benefits for students, in addition to acquiring and honing research skills which are crucial to both researchers and clinicians. Although the program currently involves only undergraduate AUB students, we envision to expand and collaborate with other universities in Lebanon and the Middle East to promote diversity in the community and expose students to a greater variety of projects. More studies are needed to support our findings and test our undergraduate research program model.

Ethics approval and consent to participate

The work described in this manuscript does not need ethical approval as indicated by the American University of Beirut Institutional Review Board (IRB). The IRB indicated that this work describes a “program improvement rather than a research protocol”.

Participants

The participants in the MRVP were undergraduate students who were informed about the program (through orientation session and announcements via email and on social media). The participants willingly participated in the MRVP and filled up all the required forms.

Consent for publication

Not applicable.

Availability of data and materials

Acknowledgments.

The authors sincerely acknowledge the generous gift of Dr. Ibrahim Durr and Mrs. Loulu Durr to establish the “Ibrahim and Loulu Durr Endowed MRVP Award”. The authors thank Dr. Hussain Ismaeel for fruitful discussions. We would also like to thank Mrs. Mona Boji and Mr. Rami Farran, from the Department of IT Academic Core Processes & Systems, for the development of the MRVP portal. Finally, we acknowledge Mrs. Hala Kaidbey’s support in the administrative MRVP tasks.

The video of the first MRVP student orientation session is posted on YouTube at: https://youtu.be/dy8OeJJhdKs . Accessed 28 April 2016.

No funding was provided for this work.

Abbreviations

Competing interests

The authors declare that they have no competing interests.

Authors’ contributions

MMD and JAA participated in the design of the MRVP and drafted the manuscript. MKS managed the development and implementation of the MRVP portal and drafted the manuscript. SK drafted the manuscript. HT and BRK conceived the MRVP, coordinated the MRVP, designed the MRVP portal and drafted the manuscript. All authors read and approved the final manuscript.

Contributor Information

Hani Tamim, Email: bl.ude.bua@mimath .

Bilal R. Kaafarani, Email: [email protected] .

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More than 20,000 volunteers have been recruited to a resource aimed at speeding up the development of much-needed dementia drugs. The cohort will enable scientists in universities and industry to involve healthy individuals who may be at increased risk of dementia in clinical trials to test whether new drugs can slow the decline in various brain functions including memory and delay the onset of dementia.

We’ve created a resource that is unmatched anywhere else in the world, recruiting people who are not showing any signs of dementia rather than people already having symptoms Patrick Chinnery

Using the resource, scientists have already been able to show for the first time that two important bodily mechanisms – inflammation and metabolism – play a role in the decline in brain function as we age.

By 2050, approximately 139 million people are expected to be living with dementia worldwide. In the UK, in 2022, UK Prime Minister launched the Dame Barbara Windsor Dementia Mission, part of the government’s commitment to double increase research funding for dementia.

Although there has been recent progress developing drugs that slow down progression of the disease, the two leading treatments only have a small effect, and the vast majority of new approaches that work in animal studies fail when it comes to patient clinical trials.

One explanation for these failures is that the drugs are tested in people who already have memory loss – and by this point, it may be too late to stop or reverse the disease. Hence, there is an urgent need to understand what is going on before people develop symptoms at the very early stages of disease, and to test new treatments before people come to their doctor with cognitive problems. This approach requires a large cohort of participants willing to be recalled for clinical and experimental studies of cognitive decline.

Today, writing in the journal Nature Medicine , scientists led by the University of Cambridge in partnership with the Alzheimer’s Society report how they have recruited 21,000 people aged 17-85 to the Genes and Cognition Cohort within the National Institute for Health and Care Research (NIHR) BioResource.

The NIHR BioResource was established in 2007 to recruit volunteers keen to engage in experimental medicine and clinical trials across the whole of medicine. Approximately half of its participants are recruited to disease specific cohorts, but the other half are from the general public, and detailed information about their genetics and their physical makeup has been collected. They have all given their consent to be contacted about future research studies.

For the Genes and Cognition Cohort, researchers used a combination of cognitive tests and genetic data, combined with other health data and demographic information, to enable the first at-scale study of cognitive changes. This will allow the team to recruit participants for studies of cognitive decline and new treatments for this.

For example, a pharmaceutical company with a promising new drug candidate to slow the cognitive decline could recruit people through the BioResource based on their profile and invite them to join in the clinical trial. Having a baseline measurement for their cognitive performance will allow scientists to observe whether the drug slows their expected cognitive decline.

Professor Patrick Chinnery from the Department of Clinical Neurosciences at the University of Cambridge and co-Chair of the NIHR BioResource, who has led the project, said: “We’ve created a resource that is unmatched anywhere else in the world, recruiting people who are not showing any signs of dementia rather than people already having symptoms. It will allow us to match individuals to particular studies and speed up the development of much-needed new drugs to treat dementia.

“We know that over time our cognitive function decreases, so we’ve plotted out the expected trajectory of various different cognitive functions over our volunteers’ life course according to their genetic risk. We’ve also asked the question, ‘What are the genetic mechanisms that predispose you to slow or fast cognitive decline as you age?’.”

Using the research, the team have identified two mechanisms that appear to affect cognition as we age and could serve as potential targets to slow down cognitive decline and thereby delay the onset of dementia. The first of these is inflammation, with immune cells specific to the brain and central nervous system – known as microglia – causing gradual deterioration of the brain and hence its ability to perform key cognitive functions. The second mechanism relates to metabolism – in particular, how carbohydrates are broken down in the brain to release energy.

Professor Chinnery added: “Cognitive decline is a natural process, but when it drops below a particular threshold, that’s when there’s a problem – that is when we would diagnose dementia. Anything that slows that decline will delay when we drop below that threshold. If you could put off the onset of dementia from 65 to 75 or even 85, it would make a huge difference at an individual and at a population level.”

Dr Richard Oakley, Associate Director of Research and Innovation at Alzheimer’s Society, said: “This exciting study, funded by Alzheimer’s Society, is an important step in helping us to better understand how the diseases that cause dementia begin, and will aid in the development of new treatments that target the early stages of these diseases.

“The data, from over 20,000 volunteers, helps us to better understand the connection between participants’ genes and cognitive decline and allows for further ground-breaking analysis in future. 

“One in three people born in the UK today will go on to develop dementia in their lifetime but research will beat dementia. We need to make it a reality sooner through more funding, partnership working and people taking part in dementia research.”

For further information about how you can join the BioResource and contribute to studies like this one and many others, please visit bioresource.nihr.ac.uk .

The research was carried out in collaboration with the Medical Research Council Biostatistics Unit and was supported by the Alzheimer’s Society and the NIHR BioResource. The researchers were also supported by Wellcome and the Medical Research Council.

Reference Rahman, MS et al. Dynamics of cognitive variability with age and its genetic underpinning in NIHR BioResource Genes and Cognition Cohort participants. Nat Med; 14 May 2024; DOI: 10.1038/s41591-024-02960-5

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• Published: 21 May 2024

Ethical perspectives regarding Euthanasia, including in the context of adult psychiatry: a qualitative interview study among healthcare workers in Belgium

• Monica Verhofstadt 1 ,
• Loïc Moureau 2 ,
• Koen Pardon 1 &
• Axel Liégeois 2 , 3  

BMC Medical Ethics volume  25 , Article number:  60 ( 2024 ) Cite this article

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Introduction

Previous research has explored euthanasia’s ethical dimensions, primarily focusing on general practice and, to a lesser extent, psychiatry, mainly from the viewpoints of physicians and nurses. However, a gap exists in understanding the comprehensive value-based perspectives of other professionals involved in both somatic and psychiatric euthanasia. This paper aims to analyze the interplay among legal, medical, and ethical factors to clarify how foundational values shape the ethical discourse surrounding euthanasia in both somatic and psychiatric contexts. It seeks to explore these dynamics among all healthcare professionals and volunteers in Belgium.

Semi-structured interviews were conducted with 30 Dutch-speaking healthcare workers who had encountered patients requesting euthanasia for psychiatric conditions, in Belgium, from August 2019 to August 2020. Qualitative thematic analysis was applied to the interview transcripts.

Participants identified three pivotal values and virtues: religious values, professional values, and fundamental medical values encompassing autonomy, beneficence, and non-maleficence, linked to compassion, quality care, and justice. These values interwove across four tiers: the patient, the patient’s inner circle, the medical realm, and society at large. Irrespective of their euthanasia stance, participants generally displayed a blend of ethical values across these tiers. Their euthanasia perspective was primarily shaped by value interpretation, significance allocation to key components, and tier weighting. Explicit mention of varying ethical values, potentially indicating distinct stances in favor of or against euthanasia, was infrequent.

The study underscores ethical discourse’s central role in navigating euthanasia’s intricate landscape. Fostering inclusive dialogue, bridging diverse values, supports informed decision-making, nurturing justice, and empathy. Tailored end-of-life healthcare in psychiatry is essential, acknowledging all involved actors’ needs. The study calls for interdisciplinary research to comprehensively grasp euthanasia’s multifaceted dimensions, and guiding policy evolution. While contextualized in Belgium, the implications extend to the broader euthanasia discourse, suggesting avenues for further inquiry and cross-cultural exploration.

Peer Review reports

Medical assistance in dying is allowed in 27 jurisdictions in the world and if so, it is mainly restricted to the terminally ill (see BOX 1 in OSF) [ 1 ]. Medical assistance in dying entails that a patient’s death request can be granted via euthanasia , defined as the intentional termination of life by a physician at the patient’s explicit request, which is currently decriminalised in Australia, Belgium, Canada, Colombia, Luxembourg, the Netherlands, Spain, and New Zealand. In addition, it can be granted by means of assisted suicide , also defined as the intentional termination of life by a physician at the patient’s explicit request, but in these cases, the lethal drugs are provided by a physician and self-administered by the patient at a time of the latter’s own choosing (e.g., Australia, Austria, Switzerland, United States). In some countries, not only a physician, but also a nurse practitioner can be involved in the procedure (e.g., Canada, New Zealand).

Euthanasia has been legal in Belgium since 2002, positioning the country as a pioneer in this field with two decades of euthanasia practice [ 2 ]. According to Belgian legislation, individuals can be deemed eligible for euthanasia when they are, among other criteria, in a medically futile state characterized by constant and unbearable physical or psychological suffering resulting from a serious and incurable disorder caused by accident or illness [ 2 ]. Belgium is one of the few countries that does not exclude people from assisted dying who suffer predominantly from irremediable psychiatric conditions (see BOX 2 in OSF for all legal criteria in Belgium). As regards prevalence, euthanasia accounted for up to 3.1% of all registered deaths in 2023 in Belgium [ 3 ]. Whereas most registered euthanasia deaths concerned the terminally ill (approximately 84%), predominantly suffering from cancer, only 48 or 1.4% of euthanasia deaths concerned non-terminally ill adults predominantly suffering from psychiatric conditions. Since euthanasia was legalised, in total 457 such euthanasia cases have been reported, less than 1.5% of all registered euthanasia cases in Belgium [ 3 , 4 , 5 , 6 , 7 , 8 , 9 ].

However, this is only the tip of the iceberg, as there is reason to believe that the total number of requests for euthanasia in Belgium (regardless of outcome), is at least 10 times higher. For instance, recent annual reports from Vonkel, an end-of-life consultation centre in Belgium, revealed around 100 unique patients per year applying for euthanasia for psychiatric reasons. Less than 10% of those euthanasia requests were reported to be carried out [ 10 , 11 , 12 ]. Moreover, a recent survey among psychiatrists working in Flanders, Belgium, revealed that 8 out of 10 respondents had been confronted at least once throughout their career with patients requesting euthanasia for psychiatric reasons [ 13 ]. The survey also showed that, although three-quarters are supportive of not excluding the option of euthanasia for this specific patient group [ 14 ], the majority is hesitant to be actively engaged in a euthanasia procedure [ 13 , 14 ]. The literature ascribed the reluctance to the complexity of euthanasia assessment in this patient group, inherently high in professional and emotional demands [ 15 , 16 , 17 , 18 , 19 ]. The complexity was for a large part described in terms of the practical considerations surrounding euthanasia requests and assessment, e.g., whether and when these patients can meet the legal criteria.

There is thus reason to believe that healthcare workers’ overarching ethical considerations influence their attitudes on euthanasia in general and in the context of psychiatry specifically, and their practice. As empirical in-depth studies are lacking, this area is largely understudied. To date, only two recent qualitative studies among Dutch physicians emphasised the value-based reasons for euthanasia decision-making, but did not [ 20 ] or only summarily [ 21 ] scratch the specific context of psychiatry. Another recent qualitative study among Dutch physicians, including psychiatrists, emphasized the value-based reasons for supportive attitudes towards euthanasia, e.g. the value of self-determination, compassion, fairness, and suicide prevention, versus the value-based reasons for not supporting euthanasia, e.g. the mission of medicine of hope and healing [ 22 ]. Furthermore, a recent systematic review described the main ethical challenges surrounding the euthanasia practice in the context of psychiatry [ 23 ]. However, this ethical debate was mainly concentrated on the permissibility and implementation of euthanasia from a practical-clinical point of view, e.g. whether euthanasia in the context of psychiatry should be permitted, and why the legal requirements can (not) be adequately embedded in the field of psychiatric medicine. How practically and juridically relevant these considerations may be, they remain the outcome of ethical values being weighed up, which means that no single consideration can be considered ethically irrelevant, neutral, or value-free. Moreover, the review was based on articles that have been selected in a timeframe in which sound empirical data regarding euthanasia in the context of psychiatry were largely lacking.

Also, the overarching value-based views of other professionals involved in psychiatric euthanasia practice have not yet been studied. This is striking, as a recent Belgian survey study revealed that that half of the psychiatric nurses (53%) are frequently and directly confronted with such euthanasia requests [ 24 ], but in-depth insights into their value-based views are lacking. Furthermore, there are many more formal caregivers, other than psychiatric nurses, involved in euthanasia assessment procedures. End-of-life centres employ e.g., paramedical personnel such as psychologists, psychiatric nurses for intake and registration purposes, and well-trained volunteer personnel such as buddies, entrusted with the task to help these patients to cope with the euthanasia procedure. In addition, rehabilitation-oriented support groups (REAKIRO) were established to help these patients (and their relatives) in walking the tightrope of life and death [ 25 ]. All of these caregivers may also have an unacknowledged but influential role in these euthanasia assessment procedures, and therefore, an interesting perspective to reflect on euthanasia legislation and practice. Gaining insight into healthcare workers’ ethical considerations related to euthanasia in psychiatry will lay bare the ethical foundations underlying current practice and is important to inform and spark further debate around this extremely thorny issue, and to promote sound ethical analysis.

Hence, the purpose of this research is to explore healthcare workers’ ethical considerations regarding euthanasia in general and euthanasia concerning adults suffering predominantly from psychiatric conditions in particular.

Theoretical research framework

Our research was guided by the framework of ‘critical social constructionism’ [ 26 ], providing a nuanced perspective that diverges from the acknowledgment of an objective reality. This approach intricately examines the interplay of personal, social, and societal dimensions within the phenomena under study. It necessitates an acknowledgment of the layered complexities influencing our understanding of phenomena such as euthanasia, a notion supported by both our prior research [ 27 ] and additional studies [ 23 , 28 ].

Our interpretation of the data was informed by social constructionism, which recognizes the role of internalized societal norms in shaping individuals’ perceptions of reality over time. Furthermore, we embraced a contextualist epistemology [ 29 ], acknowledging the contextual influence on knowledge formation among both researchers and participants. This methodological approach aimed to capture diverse lived experiences (e.g., diversity in clinical and euthanasia trajectories) and perspectives, including varied attitudes toward euthanasia based on specific relationships (e.g., professional healthcare worker or volunteer). Consequently, we maintained a reflexive stance regarding the potential impact of our individual experiences and identities on our analyses and interpretations, as elaborated in the Ethical Considerations section.

Study design

The qualitative research design consisted of semi-structured face-to-face interviews with healthcare workers in Flanders and Brussels, Belgium.

Participants

All participants were Dutch-speaking and had at least one concrete experience with euthanasia requests and procedures concerning adults with psychiatric conditions in the period 2016–2020, either as professional or volunteer healthcare workers. We adopted a broad recruitment approach, with a particular focus on all healthcare providers directly involved in medical practice rather than in managerial or policy-making roles. No further exclusion criteria were employed.

Recruitment and interview procedure

Purposive sampling was used to ensure diversity and heterogeneity in terms of: participants’ affiliation with institutions holding different stances on ‘euthanasia and psychiatry’; being to a different extent confronted with these euthanasia procedures as regards the amount of experiences (sporadically versus regularly); the nature of the experiences (e.g. confronted with or engaged in euthanasia procedures that were still under review or that had been rejected, granted, performed or withdrawn); and their specific role as professional or volunteer healthcare worker.

Participants were recruited via assistance of our contact persons at: (1) the end-of-life consultation centre Vonkel; (2) the Brothers of Charity; (3) the rehabilitation-oriented centre REAKIRO in Louvain; and (4) the Review Belgian Euthanasia Law for psychological suffering (REBEL) group, a group of Belgian physicians (e.g. psychiatrists), therapists (e.g. psychologists) as well as academics who express their concern on euthanasia in the context of psychiatry via the media. Participants were also recruited via a notice on the sites, newsflashes and/or in the online newsletters of LEIF (Life End Information Forum), Recht op Waardig Sterven (the Flemish Right to Die with Dignity Society) and Vlaamse Vereniging voor Psychiatrie (Flemish Psychiatric Association).

Potential participants contacted MV or a study assistant by phone or mail. The patients were then given an information letter and informed consent form that consisted of 2 main parts. All interviews were conducted by MV or a study assistant, who both have experience in conducting interviews on end-of-life topics. Interviews were held at the participant’s location of choice, except for five interviews which were held online via video call by Whereby 14 due to the Covid-19 crisis lockdown regulations. Interviews lasted between 55 min and 2 h, and were audio recorded (the online video interviews were recorded by Whereby’s software and immediately transferred in an mp.3 format).

Measurements

The interview guide (see OSF) contained the following consecutive questions of importance to the present report: (1) What is your personal stance regarding euthanasia as a legalised medical end-of-life option? and (2) What is your personal stance regarding euthanasia in the context of psychiatry?

Data management and analysis

We used a model of sampling-based saturation, namely inductive thematic saturation, that relates to the emergence of new themes (defined as 7 consecutive interviews without new themes) [ 30 ]. We continued to recruit and conduct interviews so that the sample would be heterogenous in terms of socio-demographics, clinical profile, and clinical setting. In particular, our focus was on recruiting individuals with the following profiles: psychologists, male psychiatric nurses and moral consultants/spiritual caregivers employed in residential psychiatric settings ( n  = 5).

All interviews were then transcribed verbatim and de-identified by the interviewers.

We made use of hybrid inductive and deductive coding and theme development by means of a 2-staged process. Stage 1 consisted of an inductive data-driven thematic coding procedure.

We made use of these four phases; (1) identification and coding of all transcripts; (2) the placing of the codes in subthemes, i.e., arguments in favour versus critical concerns; (3) the placing of these subthemes in overarching main themes, i.e., different stakeholders (patient/medicine/society); (4) the comparison and discussion of the findings (with all co-authors). In addition to the inductive approach, we also used a deductive, theory-driven template approach during stage 2. We made use of these four phases; 1) the development of an ethical interpretation framework (see OSF). The framework consists of four key concepts, each involving a multitude of ethical concepts: (a) ethical theories and methodologies, (b) ethical values, (c) basic ethical virtues, and (d) dialogue/decision making ethics; 2) the identification of codes that fit the ethical framework and the theory-driven renaming of these codes; 3) the placing of some of the subthemes in an additional main theme; and 4) the comparison and discussion of the findings (with all co-authors).

Ethical considerations

The research team comprised two experienced clinical psychologists, one specializing in euthanasia within the cancer patient population and the other skilled in conducting interviews on this sensitive topic within the adult psychiatric context. Additionally, two ethicists with expertise in assisted dying, including euthanasia, were part of the team. Some authors also have backgrounds in psychiatric practice, including outpatient and residential settings, while others bring expertise through personal experiences. Furthermore, all contributing authors have personal and/or professional connections with individuals navigating death ideation, offering diverse perspectives on euthanasia. Additionally, some authors hold religious beliefs, while others maintain a more agnostic stance. These perspectives vary depending on the predominant viewpoints adopted—whether that of the patient, a close relation, a clinician, an ethicist, or policy stances. To mitigate potential undue influence on data interpretation, three team assemblies were convened. These sessions served to share firsthand encounters from interviews and their outcomes, fostering reflection and deliberation among team members. This proactive measure was implemented to prevent both personal and professional biases from affecting the interpretation of the data.

The main characteristics of the 30 participants are listed in Table  1 . The sample consisted of 16 physicians, 7 other care professionals (ranging from psychiatric nurses to mobile support teams), and 7 volunteers, all of whom were engaged in one or more euthanasia procedures predominantly based on psychiatric conditions.

The participating physicians held various roles regarding the handling of euthanasia requests:

1 physician refused to discuss the request with the patient on principle grounds.

7 physicians managed the clarification of euthanasia requests from their own patients or referred them to colleagues for further clarification.

10 physicians provided one of the two legally required formal advices or an additional advice on the euthanasia request.

5 physicians performed the act of euthanasia.

3 physicians held a more normative, dissuasive stance against euthanasia in the context of psychiatry but were willing to explore and discuss the euthanasia request with the patient.

The sample further included 14 non-physicians, among them members holding one or more roles:

2 members were part of mobile teams providing psychiatric care and support in the patient’s home setting.

3 were psychiatric nurses working either in a general hospital or in a psychiatric residential setting.

2 were Experts by Experience, individuals with a history of mental distress trained to provide support for individuals new to the euthanasia procedure and/or rehabilitation approaches.

3 were buddies, individuals entrusted with assisting and supporting the patient throughout the euthanasia procedure.

3 were moral consultants/spiritual caregiver, tasked with offering various forms of existential guidance and support to patients considering euthanasia, including religious, moral, and/or other perspectives.

5 were consultants at end-of-life information and/or consultation centers responsible for patient intake.

Participants’ ethical considerations regarding euthanasia, in the broadest context of medicine

As can be seen from the coding structure in Table  2 , we ordered coding categories on the level of 1) the individual patient, 2) the patient’s social inner circle, 3) the (para)medical field, and 4) the society. Note that words used verbatim by the interviewees (often interview fragments instead of quotes, as to better illuminate the complexities and nuances of interviewees’ first-hand lived experiences) from the transcribed interviews are incorporated that provide both additional insightful details and reveal the at times interwoven nature of the analysed codes.”

The level of the individual patient

On the level of the individual patient, the following five ethical considerations were distinguished: (1) autonomy, (2) dignity, (3) quality of life, (4) compassion, and (5) the meaning and transformative value of suffering.

First, Autonomy was a recurrent theme in all the interviews. Some participants expressly valued individual autonomy , and more specifically its following two underpinning characteristics: (1) self-determination in terms of the fundamental right for each individual to direct the course of one’s own life, which also includes ‘taking control over the timing and circumstances of one’s end-of-life’, and (2) freedom of choice , as they strongly believed that individuals are free to choose what meaning and purpose they assign to their lives. According to them, as each individual should be enabled ‘to live according to one’s own value system’, so should the ending of one’s life also be congruent with one’s own value system. Hence, in their opinion, euthanasia should remain ‘one of the many options to die’.

Other participants called this individualistic approach of autonomy ‘unrealistic’ or even ‘delusional’, as it shies away from: (1) the relational account of autonomy, in which a true autonomous decision was seen as the outcome of a decision-making process which is shaped by individual, social and contextual components, and (2) the internalised downside of autonomy, as the feeling underpinning many euthanasia requests, namely ‘not wanting to be a burden to others’ may lead to ‘self-sacrifice’ and ‘the duty to die’ under the false pretence of autonomy. In addition, some pointed to the power of susceptibility and subliminality, as human beings are subliminal creatures whose behaviour is continuously influenced on both a subconscious and even conscious level. Consequently, internalised pressure cannot be excluded when a patient requests euthanasia. One psychiatrist even stated that ‘ there exists no such thing as a free will, as human beings are always manipulated in many areas of human life and functioning’ .

“I believe that that there should still be places in society where you could die without considering euthanasia. While many people today are facing dementia, and you almost must…. Interviewer: Yes. “Yes, like how should I deal with it? Should I exit life before it becomes inevitable dementia or something similar? Because I think that in a neo-liberal society, many people internalize the idea that at some point, it becomes a moral duty to step aside. They feel obliged to eliminate themselves. Self-elimination. In a neo-liberal model, as long as you can keep up and contribute, everything is fine. But if you can’t keep up, well, if you cannot fully exercise autonomy, then… Essentially, you should hold your honour and step aside.” (spiritual caregiver)

Second, participants mentioned euthanasia as an option to die with dignity . For those in favour of the Law, euthanasia is considered (1) a ‘dignified way of dying’ when everything that leads up to death, including individual, medical, and social needs and expectations, is consistent with one’s own sense of integrity, belief-system and lifestyle, and (2) a ‘good death’, when referring to the literal meaning of the concept ‘euthanasia’, namely ‘a soft and gentle passing’. Other participants raised concerns on the reference to euthanasia and dignified dying in the same breath, as if “ other ways of dying are not or less dignified ”.

Third, the value of quality of life underpinned the arguments made in favour of the Law on Euthanasia, as (1) life itself should not be prolonged unnecessarily, (2) meaningless suffering should be prevented, and (3) a good life should pertain to all stages in life, from the very beginning until the very end, which is feasible if quality of dying circumstances can be guaranteed. As one buddy stated: “ Living a full and good life implies dying a good death ”. Other participants made use of this value underpinning their argument against euthanasia, based on (1) the “protect-worthiness” of life itself and (2) the suffering that must be considered an inherent feature of the human condition.

Fourth, and seamlessly fitting with the former value, divergent courses also emerged regarding the aspect of how to deal with suffering . Some participants were in favour of euthanasia out of compassion in terms of (1) bringing a kind of relief to the patient when providing her the prospect of an end to the suffering and (2) ending the suffering once it has become ‘useless and meaningless’ and ‘disclosing the limits of the carrying capacity of the self’. Some participants referred to the insufficient degree of quality of life in some patients and valued euthanasia as sort of ‘ compensation for a life gone wrong’.

Others considered the option of euthanasia as compromising patients’ ability to accept, bear and cope with suffering experiences by offering the opportunity ‘to quickly resign from it’.

Some participants referred to the dynamic features and hence, the potential enriching value of suffering. They believed that one can and must revolt against the perception of pointless suffering, as suffering may offer unique opportunities to achieve personal growth through the realisation of self-actualising tendencies amidst the suffering and though all kinds of hardship and adversity in life. Therefore, the real challenge is to support the sufferer to (re)gain the ability to transform the suffering by means of redefining, accepting, and making sense of it. One psychiatrist referred to the Myth of Sisyphus and stated:

A rock that must be pushed up the mountain, which is terrible, and then Sisyphus lets the rock fall back down, and he must start all over again. And what is the purpose of that suffering? Pushing the rock up? It’s absurd, really, but still. I find it so vital, human, uh, yes. That is something that inspires me enormously and often makes me, well, yes, vitality and suffering, suffering is inherent to being, of course, and one can suffer, of course, that is very serious suffering, terrible suffering. I know that. But well, accept suffering, right? I’m not glorifying suffering, no, I don’t belong to that category. Some Catholics do that; the suffering of Christ, we must… No, not at all. Suffering is inherent to life. Interviewer: It’s just more bearable for some than for others. Interviewee: Then it’s our task to make it more bearable. Yes. (…) Look, that sets a dynamic in motion. By dynamic, I also mean movement. A euthanasia request is often rigid. I am for movement. That’s what Eastern philosophy teaches us too, that everything moves, and we must keep that movement and that the question may change or that people may also discover things. Or indeed, a suffering that is even more exposed, but on which one can then work. There is still much to do, yes, before the ultimate and final act of euthanasia, by a doctor for all sakes, should be considered. (psychiatrist)

The level of the patient’s inner circle

On the level of the social inner circle, the following three ethical considerations were distinguished: (1) involvement, (2) connectedness, and (3) attentiveness.

Some participants stressed that euthanasia can only be a soft and thus ‘good’ way of dying, if the patient’s social inner circle can be involved in the euthanasia procedure and if sufficient support to them can be provided. All participants in favour of the legal framework on euthanasia echoed the importance of the social circle being involved in an early stage of the euthanasia procedure, as the prospect of the end of life may challenge a patient’s ability of staying and feeling connected . If the euthanasia request is to be carried out, it offers a unique opportunity for both the patient and her social inner circle of consciously being present and sharing goodbyes. Other participants considered this reasoning as potentially deceiving, as concern was raised regarding the trap of false assumptions, in terms of words being left unspoken and the bottling up of one’s own needs for the sake of the other.

As the third doctor, I was asked to provide advice about someone, and the [adult child] was present, a charming [adult child]. The [adult child] was also very friendly but didn’t say much. The man explained why he himself wanted euthanasia and so on. To be honest, at first, I thought, “Well, this won’t take long,” because there were many arguments and reports I had received, but as the conversation went on, I started to feel something different. It turned into a very long conversation, during which the [adult child] also had their say. In short, the father believed that he couldn’t burden his children. He was a kind man who knew what he wanted, and his children were inclined to follow his idea, to follow his vision. However, the children thought, “Yes, we are actually going to agree with our father, and we’ll allow it,” but deep down, they still wanted to take good care of him. The father didn’t want them to take care of him, and there were many other things, but after that long conversation with the [adult child] and the father, and everything else, like, “We’ll still celebrate Christmas together,” there was a complete turnaround. The other physicians involved accepted this very well, and they said, “Okay, for us, it wasn’t clear. (physician)

In addition, concern was raised regarding the inner circle’s respect of individual patient autonomy and freedom of choice outweighing their r esponsibility and accountabilit y to take care for one another and to act according to all these subjects’ best interest.

Consequently, divergent discourses on the virtue of attentiveness emerged. Whereas for some, the euthanasia procedure may offer a unique opportunity for both the patient and her relatives to be better prepared for death and for the bereaved to better cope with grief, others pointed to the inner circle’s continued grappling with unresolved feelings and perceived helplessness after such a fast-track to death.

Yes, and sometimes I also see people, family members after such euthanasia, yeah, I’ve experienced it several times. They say things like, “Yes, I supported it, but I didn’t know it would affect me like this,” you know? They try to convince themselves, saying, “It was good, it was good, and I stand behind it.” Yeah, you are hardly allowed to do otherwise, but you feel that inner struggle in them, you know? Like, “Was it really okay?” But you can’t question it because you think, “Poor them,” but you still feel it, like, “How sad, how sad. (psychiatrist)

The level of medicine

The following five ethical considerations were distinguished: (1) professional duties, (2) responsibility to alleviate suffering, (3) subsidiarity, (4) professional integrity, and (5) monologic versus dialogic approaches.

First and as regards professional duties, it was (only) reported by some physicians that the physician’s duty is “ to provide good care, which includes good end-of-life care ”. Hence, physicians are the ones who should have euthanasia “as a tool in their end-of-life toolbox”. Others held a different stance and referred to Hippocrates’ Oath when stating that the physician’s duty is to save life at all costs.

Second, all the participants agreed that clinicians have the responsibility to alleviate the patient’s suffering . Whereas some welcomed the option of euthanasia due to the experienced limits of palliative care, that in some cases is deemed an insufficient response to intractable suffering, others stated that euthanasia is not needed as physicians have proper palliative care in their toolbox to alleviate all kinds and degrees of suffering.

Third and as regards the subsidiarity principle , opinions differed on the use of a palliative filter, i.e., whether a consultation with specialist palliative care units should precede euthanasia.

Fourth and as regards professional integrity , some participants relativized the physicians’ executive autonomy. As one psychiatrist stated “because in the end, we do not decide whether someone might die or not. We only decide whether we want to be of help and assist in it.” All the ones in favour of the current legal framework echoed that as physicians are the ones that have better access to the lethal drugs and the technical expertise to end the patient’s life in more efficacious ways than non-physicians, they should remain entrusted with euthanasia assessment procedures. Others (only physicians) criticized the Belgian legislator for placing too much power in the physicians’ hands so that the latter “ can play for God instead of using their pharmacological and technical know-how to save lives ”.

Fifth, and as regards the decision-making process, most participants valued the ethical principle of shared decision-making between the patient and her physicians, and some even preferred a triadic dialogue in which the patient, her relevant health carers and her social inner circle is involved in euthanasia assessment procedures. For most of them, this type of extended or relational autonomy is considered as best clinical euthanasia practice, especially when death is not foreseeable. According to some non-physicians, a strict dyadic patient-physician approach is to be preferred when death is reasonably foreseeable in a patient with sufficient mental competence. In this event, no intermediary should be tolerated as the medical secret is considered ‘sacred’. One participant elaborated further on this strict dyadic approach and said:

“ But actually, in my opinion, the request for euthanasia is something between two people. So…. Interviewer: The singular dialogue? “So, a relationship between the patient and the doctor, yes. That’s what I think. And I do understand that the legislation exists, primarily to protect the doctor against misuse or accusations, because euthanasia used to happen before too, but in secret. But for me as a doctor, it would be enough if a patient whom I’ve known for years, followed for years, maybe 20 years, 30 years, 40 years, and who is terminally ill, asks me in private, ‘I want it.’ For me, it doesn’t need to be more than that for me to say, ‘yes.’ So, there’s no need for a whole set of legislation, except of course to protect myself, maybe from the heirs who might have a different idea about it, yes, but I find it beautiful. And they say, you know, our legislation is such that you can write your euthanasia request on the back of a beer coaster and that’s enough, you know? But how it used to be, euthanasia happened just as well, that’s what I heard from my older colleagues. But it was done in private. Actually, that is the most beautiful sign of trust between a doctor and a patient. ” (Physician and consultant)

Others, all physicians without a favourable stance on euthanasia, considered medical paternalism morally justified in the end-of-life context, as (1) physicians have more intimate knowledge of the patient and are thus best placed to act in the patient’s best interests, (2) only the independent evaluation from well-trained and experienced physicians may rule out external or internalized pressure from the patient’s social inner circle, and (3) some patients may show impaired decision-making capacity when confronted with the end of life.

The level of society

As regards the origins and impact of euthanasia legislation on the level of society, the following four ethical themes emerged: (1) protection, (2) dignified dying, (3) solidarity, and (4) distributive justice.

First and as regards protection , some participants valued the existence of a legal framework for an ‘underground’ practice before 2002. According to them, this framework was highly needed to protect the patient against malicious practices and the physician against being charged for murder when ensuring herself that all the legal requirements are met.

So, I believe that it should be well-regulated in a state. In a country, it should be well-regulated. You can either be in favour of it, have reservations, or question it, but when it happens and many people want it or think it’s okay, then it should be regulated. And those, like me, who may be against it, have doubts about it, or wonder, “Is this really necessary?” I would say, or “Does it align with our purpose?” the existential comments that you can make about it, we must accept it because it would be terrible if it, well, it would be even worse if it happened in the underground, like before those laws were established, that’s, yeah. So, I think the laws should exist. Whether I would have made those laws is a different question, or whether I would vote for the parties in parliament that, you know, that support it, that’s another question, but apparently, here in North-western Europe, the need for those practices exists, and it should be regulated properly. And yes, it shouldn’t be left to amateurs or something like that, that’s not the intention. Yes, well, it serves to protect, both in terms of health and to ensure that it doesn’t become a business, of course. I’d prefer it to be integrated into the healthcare system rather than turning it into a profit-driven and exploitative affair for some others. So, that’s…. (psychiatric nurse)

Critical concerns were raised on the lack of protection of the most vulnerable people, i.e., the mentally ill and the elderly. Some of them referred to the amended Law in 2014, that also allowed minors to die by means of euthanasia – be it under more strict circumstances, inter alia, when based on unbearable physical suffering resulting from a medically terminal condition – and feared that the Law will be amended again, so it would no longer exclude the people suffering from dementia or for groups without serious incurable illness, e.g., the elderly with a perceived ‘completed life’.

Second, a major societal shift in thoughts regarding what constitutes dignified dying was reported. For some, the Law on Euthanasia reflects a nascent movement of death revivalism, in terms of people reclaiming control over their dying process. In this respect, euthanasia is deemed a counterreaction to the former dominant paternalistic attitude in Western society to systematically marginalise conversations on death and dying, e.g., due to the mechanisms of denial, avoidance, and postponement, and with the line between life and death increasingly held in physician’s hands, which has left many people ill-equipped to deal with dying and death. The current broad public support for euthanasia is seen as the individual patient taking back the decision-making process of dying and death in her own hands. They further considered euthanasia as a logical consequence of living an artificially prolonged life due to e.g., advances in medicine, that have not necessarily enhanced the quality of life.

“ One thing I also consider is that a part of our lives is artificially prolonged, you know. We don’t live longer because we are healthier, but because we have good pills or better surgical procedures, so we can afford to buy our health. So that part of life is still valuable to me, it’s not less valuable, but it’s artificially extended. So, I think we should keep that in mind, that we can prolong something artificially and maybe even go beyond a point where it no longer works. Interviewer: Beyond the expiration date? That’s what I was looking for (laughs). So, in that sense, I believe we should keep in mind that we can artificially extend something and then maybe, even if it’s just that artificial part, stop or be allowed to stop when the person no longer wants to, I think that makes perfect sense. ” (psychiatrist)

Others provided arguments against the increased death revivalism, referring to euthanasia as a ‘fast-track to death’ resulting in ‘the trivialisation of death’ in the face of formerly known and experienced Art of Dying. For instance, the current societal tendency to avoid suffering and the fear of dying may lead to patients (too quickly) resigning from a slow track to death, in which there is time to e.g., hold a wake.

But I won’t just grab a syringe, fill it up, and administer a lethal injection, you know? I follow the symptoms. And if they become uncomfortable, then I’ll increase the dosage so they can rest peacefully and not have to suffer. That’s what I call a dignified death. And if the family can be present, sometimes it takes a while for them to arrive, and they’ll say, “Come on, even a dog is not allowed to suffer that long.” Meanwhile, the person is just lying peacefully. But that too. Everything should, even that, should progress, and there isn’t much time left for vigil and, yes, I don’t want to romanticize it, but sometimes you see so much happening between families. There’re all kinds of things happening in those rooms, with the family, reconciliations being made. Memories being shared. “Oh, I didn’t know that about our father.“, an aunt walking in and telling a story. Well, so much still happens. I don’t want to romanticize it, but to say that all that time is useless, that’s not true either. And at the farewell, there’s always, the time, you think there’s time for it, but people are still taken aback when an infusion is given, that it can happen within a minute, even if they’re behind it and have been informed beforehand. Just a minute… and it’s done. The banality of death, it’s almost like that. (psychiatrist)

These and other participants also criticised ‘the romanticised image of euthanasia’, that masks the economics of the death system, taking financial advantage of ‘patients not wanting to be a burden to society’.

Third and consequently, divergent discourses on the value of solidarity emerged. For some, decades of civic engagement pointed to the need of death revivalism and patient empowerment, that resulted in the current legal framework. Others strongly criticised the lack of solidarity underpinning the legal framework on the following three counts: 1) the emphasis on patient autonomy is deemed a ’societal negligence in disguise’, as citizens are no longer urged to take care of others, 2) equating autonomy and dignity in euthanasia debates leads to the trap of viewing the ill or the elderly as having ‘undignified’ lives, and 3) wealth over health has become the credo of the current neoliberal society, as the Law on Euthanasia discourages further investments in health care but settles on the ‘commodification’ of health care.

“ I believe that we should take care of each other and especially care for the most vulnerable in our society. We shouldn’t just leave them to fend for themselves. I don’t think the motto should be all about autonomy, autonomy, and then the flip side, saying, “figure it out on your own.” That’s not acceptable. We have a responsibility to take care of each other. We are meant to care for one another. In biblical terms, we are each other’s keeper, right? “Am I my brother’s keeper?” Yes, I am my brother’s keeper. I must take care of each other, take care of others. So, I think in the long term, speaking maybe 100 years from now, people might say, “Sorry, that was a real mistake in the way they approached things.” I don’t know, but that’s looking at it from a meta-level, as historians call it, “longue durée,” and combining it with a neoliberal model, right? Neoliberalism and euthanasia thinking, it would be interesting to do a doctoral thesis on how they fit together perfectly. How they fit together perfectly… They are no longer patients, they are no longer clients, and I also don’t like the word ‘clients.’ They have become ‘users’. Sorry, but that’s our Dutch translation of the English word ‘consumers’ right? It’s like buying Dash detergent or a car; you buy care, just like the Personal Budget for people with disabilities. You buy your care, sorry, this goes against the very essence of what care fundamentally is. Care is a relationship between people; it’s not something you buy. It’s not something you say, “It’s a contract, and I want that.” It doesn’t work like that. [raising voice] The burden is on society. [end of raising voice] And when the money runs out, you have nothing left. If you can’t buy it, then it doesn’t come. “Here’s your little package,” that’s how it’s translated, and it’s always a hidden cost-cutting operation, let’s be very honest about it, a nice story, but it’s always a hidden cost-saving measure. I see right through that story, but well, big stories are always told, and they are always about saving money. [raising voice] It doesn’t bring anything, right? [end of raising voice] People’s self-reliance, they must stay at home, etc. How many people would benefit from going to a care centre, not at the end of their lives, but just because they feel totally lonely at home, but they can’t get in because nobody wants them there, as they don’t bring any profit. ” (spiritual caregiver)

Fourth, critical concerns were expressed concerning the lack of (distributive) justice due to the many existing misperceptions and misconceptions regarding medical end-of-life options that need to be uncovered. For instance, many people would be unaware of euthanasia and palliative sedation can both be dignified ways of dying, with euthanasia functioning as a fast-track and palliative sedation functioning as slow track to death. Also, the evolution of death literacy was contested: there was a sense that patients did not become more death literate, as many of them have insufficient knowledge of the content of the many end-of-life documents in circulation.

Yeah, I mean, you see, and I hear many people saying, “My papers are in order.” I won’t say every day, but I hear it almost every day, “My papers are in order.” That’s also something. It’s an illusion of control, right? Because what papers are they talking about? “My papers are in order.” When you ask them about it, they themselves don’t really know what that means, some kind of ‘living will’, ‘an advance care plan’, but yeah, with all… A living will or advance care plan is not that simple either, and then they think, “Oh, if I get dementia and I don’t recognize anyone anymore, they will give me an injection.” Ah yes, but then we are in a different domain, and that’s a whole other… But yeah, people are not well-informed, I find. They have totally wrong ideas and sometimes fear the wrong things, don’t know what is possible and what is not, and they also let themselves believe all kinds of things. Well, there are many misconceptions out there. (psychiatrist)

Participants’ ethical considerations regarding the additional procedural criteria for people with a non-terminal illness

As can be seen from the coding structure in Table  3 , participants made use of the principle justice to motivate their stance on additional (procedural) criteria that people with a non-terminal illness must meet before euthanasia can be carried out, in comparison with people with terminal illness. Those in favour of the additional procedural criteria referred to the differences between the terminally ill and the non-terminally ill regarding the aspect of content (i.e., the difference between general life expectancy and healthy life expectancy) and the aspect of time (i.e., the probability verging on certainty concerning the terminally ill versus the rough estimation concerning the non-terminally ill). Some of them also referred to the legal proceedings and stated that the Law was meant only for people with terminal illnesses to die by means of euthanasia. Others were of the opinion that it concerns only an arbitrary difference due to 1) the vagueness of the concept ‘naturally foreseeable’, i.e., suffering from a terminal illness, and the subjectivity of the calculated course and prognosis of e.g., degenerative somatic illnesses and dementia. A few participants said that this is beside the question, as one’s individual carrying capacity trumps the course and prognosis of an illness.

Participants’ ethical considerations regarding adults with psychiatric conditions

As can be seen from the coding structure in Table  4 , when asked about participants’ stances on euthanasia in the context of psychiatry, we distinguished value-based themes at the level of (1) the patient, (2) the field of psychiatry, and (3) society in general.

The level of the patient

Justice was the main value-based principle that emerged at the level of the patient. Participants in favour of not legally amending additional procedural criteria in the context of psychiatry stated that every patient with a non-terminal illness should receive equal end-of-life care options. The main counterargument given concerned the differences in patient profile, as some questioned whether the mentally ill can meet the legal criteria or stated that extreme caution is needed and thus additional criteria are in place due to the factor of e.g., ambiguity, impulsivity, and manipulation in the mentally ill.

“I find, the way the procedure is conducted for psychiatric suffering, I find it only natural that they handle it more cautiously because it’s indeed less… It’s not so easy to determine everything, is there really no other option left? And then I understand somewhere that time must be taken to investigate all of that. Because some of these people can be very impulsive, and that impulsivity needs to be addressed somewhere, of course. You also have people who can use their setbacks in the sense of, ‘I’ve been through all that, so I deserve euthanasia.’ And those are the people you need to single out because that’s just… I think those are also people who, with the necessary guidance, can still get out of it. Do you understand? It’s a form of self-pity, in a way. I think there might be resilience there, but they haven’t tapped into it themselves yet; it’s a kind of deflection or something. People with a history of, who say ‘I’ve experienced this and that, so I don’t need it anymore, just give me euthanasia, I deserve that. I’ve been through all that.’ While maybe, if they see, that’s still worth something to me, who knows, maybe that can still happen. They’re people who give up a little too quickly.” (Moral consultant)

Regarding the field of medicine, the following four value-based considerations emerged: (1) justice, (2) responsiveness to suffering, (3) protection, and (4) proportionality.

First, and as regards the principle of justice , participants in favour of equal procedural criteria for all non-terminally ill pointed to the indissociable unity of soma and psyche. A few physicians went one step further and reported that some psychiatric conditions can be considered terminal, e.g., suicidality, or predominantly of somatic nature, e.g., anorexia. The main counterarguments in this respect were (1) the firm belief in the inexistence of irremediableness in psychiatry (only mentioned by some physicians) or (2) that more caution is needed due to the higher level of subjectivity in terms of diagnostics, prognosis, and outcome.

Second, arguments against the distinction between the somatically versus the mentally ill were based on the attitude of responsiveness to the extreme extent and duration of mental suffering that can also render the mentally ill in a medically futile situation and the field of psychiatry empty-handed.

And many of the psychiatric patients I see suffer more than the average ALS patient who has to endure it for three years. In my experience, we’re less advanced in psychiatry compared to most other medical fields. You can easily say “we don’t know” in other areas of medicine and people will understand, but when it comes to psychiatric conditions, it’s different. Doctors might admit “it’s not working” or “there’s no trust,” and they might refer patients elsewhere or even refuse further appointments. I’ve even told a judge during a forced admission, “There’s simply no treatment available.” Yes, sometimes it’s just over and society must accept that there’s no solution. I’m not saying euthanasia is the solution for everyone, but I think it can be an option for some people. (Psychiatrist)

Other participants were not blind to the deep suffering, but strongly believed in the ground principle and core strength of psychiatry, namely the beneficial effect of hope. In addition, they pointed to the differences in the nature and course of somatic versus psychiatric illnesses when stating that considerably more time is needed in psychiatry, with inclusion of the therapeutic effect of hope to become effective.

“And I also believe that collectively, within psychiatry, we can and must provide additional support to endure profound despair. So, even in the face of seemingly endless hopelessness, we must maintain hope, look towards the future with trust, and continuously offer encouragement to those who feel hopeless. Our unwavering optimism and support convey the message that together, we can overcome. Because individuals who suffer from severe mental illness are treatable, I consider myself to be a genuinely optimistic psychiatrist. I have witnessed individuals who have harbored feelings of hopelessness and despair for extended periods, sometimes even decades, undergo profound transformations and experience significant improvement, and in some cases, complete recovery.” (Psychiatrist)

Third, participants in favour of the current legal framework reported that allowing euthanasia for the mentally ill was needed in the light of protection , as it might protect the patient against brutal suicides and also against therapeutic tenacity that more often occurs in psychiatry. Other participants in favour of, as well as participants against the current framework held a different stance on the following two counts: (1) allowing euthanasia conflicts with the aim of psychiatry to prevent suicide at all costs, and (2) the mentally ill are insufficiently protected by the Law as there are insufficient built-in safeguards against therapeutic negligence.

But usually with a psychiatric condition, death isn’t imminent. That’s the tricky part, you know? How many suicides do we have here? But anyway, I have an issue with that, using euthanasia as a kind of antidote against, well, against suicide, that’s a completely different matter. But death and psychiatry, why do we have all those government programs against suicide then? Isn’t that dying as a result of a psychiatric condition? (Psychiatrist, supportive of maintaining euthanasia option in psychiatric settings)

Fourth and as regards proportionality , a few participants with a normative stance against euthanasia in the context of psychiatry argued that psychiatric patients may not be allowed to die by means of euthanasia for as long as the field of psychiatry is under-resourced. They pointed to e.g., the lack of sufficient crisis shelters with a 24/7 availability and the lack of palliative approaches in the field of psychiatry. Instead of allowing euthanasia, they argue ‘to jolt the Belgian government’s conscience on mental health policies’. As a revolution to defeat the built-up inequalities in the field of medicine and knowing that palliative and rehabilitation initiatives in psychiatry require time.

“I oppose euthanasia in psychiatry. Compared to somatic medicine, psychiatry lags behind by 50 years. While physical pain can be managed with medication, there’s insufficient research on treatments for psychological suffering. Promising options like psilocybin and ketamine show potential in easing existential mental struggles. Magnetic stimulation can also alleviate depression, yet access remains limited. Unfortunately, these treatments are underused and under-researched. Many patients aren’t informed about these alternatives to euthanasia. It’s frustrating to see reluctance in exploring these options, especially when they offer hope to long-suffering patients. Utilizing these methods in psychiatric settings carries no risk of addiction. However, current restrictions impede access to these treatments, depriving patients of viable alternatives.” (Shortened excerpt from an interview with a psychiatrist)

When taking a societal perspective, no new arguments emerged from the respondents strongly in favour of the current euthanasia legislation, other than the main value of justice described in the subsection above. According to some, the current Law on Euthanasia busts some myths on the malleability of life and medical omnipotence, and even on psychiatric illnesses as a ‘Western phenomenon’, with e.g., depression and suicidality as a consequence of material wealth instead of a neurologic issue in the brain (only reported by some non-physicians).

There are quite a few people who consider the whole issue of the unbearable nature of psychological suffering a luxury problem, you know? They say something like, “Yeah, where are the suicide rates, to put it in equivalent terms, the lowest in the world? In Africa, because they obviously don’t have the luxury to concern themselves with that. They are already happy if they have a potato on their plate every day.” This is a viewpoint held by many, right? They call it a luxury problem, a modern, typical Western luxury problem. And perhaps there is some truth to it, right? But there are other causes of mortality there, which are much higher, such as child mortality, for example. (non-physician)

Counterarguments were also given and pointed to the value of (distributive) Justice. First, euthanasia was considered as ‘a logical but perverse consequence of systemic societal inequities’ on the one hand and the ‘further evolution towards the commodification or commercialisation of health care in individualised Western societies’ on the other. This would then lead to another vicious circle, with a rapidly growing ‘perception of vulnerable patient groups as irremediable’ and hence less likely to receive potentially beneficial treatment or other interventions. Some took a more radical stance against euthanasia in psychiatry, as they were convinced that euthanasia is nothing but ‘a perverse means to cover societal failures’. In addition, some participants with permissive stances on euthanasia in the context of psychiatry pointed to gender disparities in euthanasia requestors. This was based on the evidence that in the context of psychiatry, many more females request and die by means of euthanasia than males, and proportionally more female patient suffering from psychiatric disorders request and die by means of euthanasia compared to their fellow peers suffering from life-limiting or predominantly somatic conditions.

Finally, some respondents said that they could understand and, in some cases, even support euthanasia in some individual cases, but felt uncomfortable with its impact on the societal level. They pointed to the vicious circle of stigma and self-stigma that may impede the mentally ill to fully participate in societal encounters. In the long run, this type of societal disability may lead to vulnerable patients no longer wanting to perceive themselves a burden to society or to remain ‘socially dead’.

While considering their ethical perspectives towards euthanasia, participants weigh up various values related to and intertwining with the following levels: (1) the patient, (2) the patient’s inner circle, (3) the field of medicine, and (4) society in general. Overall, the participants shared an amalgam of ethical values on each of these four levels, regardless of their stance on euthanasia. It was mainly the interpretation of some values, the emphasis they placed on the key components underpinning each value and the importance they attach to each of the four levels, that determined their stance towards euthanasia. It was uncommon for different ethical values to be explicitly mentioned, which could distinguish distinct stances for or against euthanasia.

As regards euthanasia in the context of psychiatry, the focus has primarily been on arguments for and against euthanasia [ 23 ]. However, our study takes a more comprehensive approach, exploring the issue from a wider range of perspectives. This approach allowed us to uncover more complex insights that may have been overlooked if we had only considered it as a black-and-white issue.

Both the systematic review of Nicolini et al. [ 23 ] and our study emphasized fundamental ethical domains such as autonomy, professional duties, and the broader implications of euthanasia on mental healthcare. While our findings aligned with those of the systematic review, our inquiry delved deeper into psychiatry-specific considerations, including the influence of sudden impulses and feelings of hopelessness. This underscores the importance of healthcare professionals carefully assessing the timing and contextual aspects of such decisions within psychiatric contexts, ensuring individuals receive timely and tailored support and interventions.

Furthermore, our study extended beyond the boundaries of medical discourse, addressing broader societal ramifications. Participants engaged in discussions about ‘social death,’ a phenomenon that describes the marginalization of individuals despite their physical existence. This discussion highlighted entrenched structural inequities and societal attitudes perpetuating social alienation, particularly affecting marginalized demographics, including individuals grappling with mental health issues. Advocating for societal inclusivity and supportive measures, our study strongly emphasized the need to foster a sense of unity and respect for everyone’s worth, regardless of their circumstances.

Interpretation of the main findings

We make explicit and discuss the values corresponding to the four classical principles of biomedical ethics, in particular beneficence, non-maleficence, respect for autonomy and justice [ 31 ]. We place these values in the context of different ethical approaches, such as religious, professional, emancipatory, social, societal, and virtue-oriented approaches (see the ethical interpretation framework in OSF).

In the discussion section, therefore, the following main values and virtues are addressed: (1) the values of beneficence and non-maleficence in a religious perspective, (2) those same values in the professional context, (3) the value of autonomy in the contemporary emancipation paradigm, (4) the virtue of compassion stemming from virtue ethics theory, (5) the value of quality care in a social approach, and (6) the value of justice in societal policy contexts.

Beneficence and non-maleficence: religious perspective

In the realm of euthanasia debates, the interplay of religious beliefs and the values of ‘beneficence’ (the act of doing good) and ‘non-maleficence’ (do no harm) has emerged as a pivotal point of contention, often giving rise to divergent perspectives on this complex ethical issue [ 32 , 33 ]. Some religious traditions staunchly oppose medical end-of-life decisions, including euthanasia and abortion, viewing them as morally wrong and as disruptive to the natural order of life and death. The principle of ‘sanctity of life’ forms the bedrock of their belief system, underscoring the significance they attach to preserving life at all costs, as an embodiment of beneficence [ 34 , 35 ]. Conversely, those who argue for the ethical consideration of euthanasia emphasize the concept of beneficence in alleviating suffering and granting autonomy to individuals in their final moments. However, intriguingly, our examination of the topic has revealed a nuanced relationship between religious beliefs and attitudes toward euthanasia. While some individuals in our sample expressed strong religious convictions ( n  = 5) and even considered themselves as practicing Catholics, they did not necessarily adopt a firm normative stance against euthanasia, signifying a complex balancing of beneficence and possible maleficence within their belief system. Conversely, certain participants who held steadfastly against euthanasia ( n  = 3) did not identify with any religious belief system, yet their position was firmly grounded in their perception of potential maleficence associated with medical intervention in life and death decisions. This observation aligns with recent studies highlighting the intricate and multifaceted nature of religiosity, where individuals within various religious frameworks may hold diverse beliefs and values surrounding beneficence and non-maleficence [ 36 , 37 ]. Moreover, it underscores the powerful influence of societal culture on shaping personal perspectives on euthanasia, and how these views are entwined with the values of beneficence and non-maleficence [ 36 , 37 ].

Beneficence and non-maleficence: professional values

Second, a profound division arises between proponents and opponents, particularly in the field of medicine, where interpretations of the Oath of Hippocrates play a central role. At its core, the Oath emphasizes the deontological values of beneficence and non-maleficence, as physicians are bound by a prohibition against administering a deadly drug to ‘anyone,’ even at their explicit request, highlighting the reverence for the sanctity of life inherent in medical practice. This interpretation has led some to perceive active euthanasia as contrary to these sacred principles of preserving life. The notion of beneficence, understood as promoting the well-being of patients, appears to be in tension with the act of intentionally ending a life. Critics argue that euthanasia undermines the fundamental duty of physicians to protect and preserve life. Additionally, the principle of ‘non-maleficence,’ which entails not harming the patient or their life, is seen by some as being in accordance with the ‘sanctity of life’. However, the Oath also recognizes the significance of alleviating relentless suffering, opening the door to a nuanced debate on how these timeless principles align with the modern concept of euthanasia. As the discourse unfolds, perspectives emerge, with some viewing euthanasia as a compassionate form of care, that respects the autonomy and dignity of patients facing terminal illness or unbearable suffering. Advocates argue that euthanasia can be an act of beneficence, providing relief from pain and allowing individuals to die with dignity and control over their own fate. On the other hand, opponents of euthanasia steadfastly uphold the sanctity of life principle, viewing it as an ethical imperative that must not be compromised. They argue that intentionally ending a life, even in the context of relieving suffering, undermines the fundamental values of medical ethics and the intrinsic worth of every human life. For these individuals, euthanasia represents a profound ethical dilemma that conflicts with the near sanctity of medical ethics and the value of preserving life [ 38 , 39 , 40 ].

Autonomy: contemporary emancipation paradigm

The principle of autonomy emerges as one of the most prominent and contentious values in our contemporary emancipation paradigm. Autonomy, grounded in the belief in individual self-governance, is often cited as a foundational ethical principle in euthanasia legislation, emphasizing the significance of an individual’s capacity to make choices aligned with their own personal values and desires [ 31 ]. However, the discussion on autonomy extends beyond pure individualism, with considerations for relational autonomy, recognizing that individuals are not isolated entities but are shaped by their relationships, communities, and broader societal structures [ 41 ]. Within the context of euthanasia, the complexities of autonomy become evident as participants in the debate strived to find a delicate balance. On one hand, they stress the importance of respecting a patient’s individual autonomy in end-of-life decisions, ensuring that their choices are honoured and upheld. Simultaneously, they acknowledge the necessity of accounting for the patient’s social context and broader community when considering euthanasia as a compassionate option. Nevertheless, concerns are raised by some about the potential risks posed by euthanasia legislation, particularly for the most vulnerable individuals, such as the elderly and the mentally ill. These concerns centre on the negative consequences that may arise when individual autonomy is exercised without consideration for others or for societal well-being, and the concept of “social death,” which refers to the marginalization and exclusion of individuals from social relationships and networks due to illness or disability [ 42 , 43 ].

Amidst these complexities, the ethical value of autonomy stands as a paramount consideration. However, its application necessitates thoughtful consideration and balance with other values, including justice, equality, and societal responsibility. Recent reflections on “relational autonomy” have prompted critical evaluations of the idea of pure autonomy, emphasizing the need to delve deeper into the micro, meso, and macro levels that underpin autonomy and address potential conflicts between individual and relational autonomy [ 44 ]. Further, it highlights the imperative to take the broader societal context into account when grappling with the ethical challenges associated with euthanasia [ 45 ].

Compassion: virtue ethics

Our study confirms that while the value of autonomy holds importance, it is not the sole determinant in the ethical considerations surrounding euthanasia [ 46 ]. In this complex discourse, numerous other ethical values and virtues come to the fore, including the significance of compassion towards suffering individuals and the imperative of alleviating their distress. Notably, compassion is not merely a singular principle, but rather a profound ground attitude or virtue that motivates individuals to empathize with the pain of others and take actions to provide relief.

As revealed in our research, participants who opposed euthanasia did not invoke religious frameworks; instead, they explored diverse philosophical approaches to comprehend suffering and compassion. Among these, non-Western philosophies emphasized embracing suffering as an intrinsic aspect of life, acknowledging the impermanence of all things, including suffering. Additionally, the existentialist perspective of Albert Camus underscored suffering’s innate connection to human existence, leading to deeper self-understanding and comprehension of the world.

These philosophical viewpoints find relevance in the realm of ethics as well. Virtue ethics, in particular, highlights the significance of cultivating virtues such as courage and resilience, while narrative ethics emphasizes storytelling as a means to gain profound insight and reflection on experiences of suffering [ 47 , 48 ]. Such narratives foster empathy and create a shared sense of experience and community.

Our results show that, for some, suffering may hold positive value in various ways. The nature and intensity of suffering, alongside an individual’s values and virtues, beliefs, and coping capacity, significantly influence the ethics of euthanasia decision-making. An intricate approach that recognizes the multifaceted impacts of suffering becomes essential, acknowledging that various factors could potentially influence the experience of suffering as well as the interpretation of the consequences of the suffering experience. It’s possible that this approach doesn’t solely depend on the quantity of suffering or even its nature. Instead, it could be related to the delicate balance between one’s ability to endure suffering, the burden it places on them, and the (ir)remediableness of this burden, which can vary greatly among individuals as well as it might change over time. Such an approach aims to alleviate relentless suffering and, in certain cases, relieve unnecessary and enduring distress without consistently imposing interpretations upon it. Thus, acknowledging that, experiences of suffering are inherent to life and might act as drivers for personal development, fostering resilience, empathy, and a deeper apprehension of life’s essence, while it also might represent something irremediable, underscores the significance of a broader meaning of the concept of compassion as guiding principle in euthanasia discussions. These discussions further extend to the recognition of the dynamic trajectory inherent to the burden of suffering, as well as its potential for temporal evolution within the individual experiences of the afflicted. Such recognition not only fosters a more intricate understanding of the complex interplay between suffering and resilience but also highlights the acknowledgment that there may be moments when suffering becomes unendurable, surpassing the individual’s capacity to cope. This dimension introduces a layer of intricacy to the ethical considerations inherent in these discussions, thus necessitating a nuanced approach that contemplates the potentialities as well as the constraints of human endurance and the associated ethical ramifications.

Quality care: social approach

Examining euthanasia debates from a sociological perspective sheds light on the influence of societal inequalities in healthcare access and quality on the practice of euthanasia, and how it can shape personal, relational, and societal values, leading to the normalization or culturalization of euthanasia [ 49 ]. A noteworthy finding in this context is the contrasting perspectives on the evolving process of dying, transitioning from being perceived as in God’s hands to a more medical realm, where proponents of euthanasia view medicine as a catalyst for granting individuals greater control over the timing, manner, and circumstances of their own deaths. They envision the opportunity to be surrounded by loved ones and maintain consciousness while embracing the option of euthanasia, which they believe improves the quality of life at the end.

Proponents also emphasize additional benefits, such as enhanced transparency and regulation, ensuring ethical conduct through regulatory measures. They express concerns about a cultural environment where certain physicians adopt paternalistic attitudes and resist accepting death, prioritizing the extension of life as a moral imperative. In contrast, critical voices argue that death and dying have become increasingly medicalized, leading to their institutionalization. Some critics further contend that this medicalization has devalued the dying process and commodified life itself, leading patients, and families to increasingly rely on medical interventions at life’s end.

Moreover, as shared by some of the interviewees, the growing acceptance of medical assistance in dying may raise concerns. It’s conceivable that this evolving attitude could contribute to a perception of death undergoing a shift in seriousness, resulting in decisions about one’s life conclusion being made with less comprehensive thought and insufficient reflection. Consequently, this scenario could potentially lead individuals who are more susceptible to experiencing feelings of life’s insignificance, weariness, or sense of being ‘through with life’, to lean towards considering euthanasia. However, this inclination might also be driven by a lack of sufficient access to the necessary, long-term quality mental health care that would otherwise facilitate the pursuit of a life imbued with adequate significance, comfort, and dignity, achievable through appropriate (mental) healthcare.

Earlier research indicates that Belgium’s psychiatric care system has been grappling with underfunding and fragmentation, leading to individuals falling through the gaps in the mental health safety net [ 50 ]. One critical aspect is, e.g., the inadequate investment in long-term, intensive care, which is precisely the kind of support that individuals grappling with such existential questions may require.

Hence, in the context of euthanasia debates, the value of quality care emerges, encompassing the principle of beneficence, which emphasizes the obligation to provide good care and enhance the overall well-being of individuals. Ethical considerations go beyond the individual’s right to autonomy, extending to societal factors that influence healthcare practices and attitudes towards euthanasia. Addressing the impact of healthcare disparities and the medicalization of dying becomes imperative to ensure ethical and compassionate decision-making that upholds the true value of quality care and respect for human dignity.

Justice: societal policy contexts

In the context of euthanasia in somatic versus psychiatric medicine, ethical considerations regarding euthanasia often revolve around the fundamental value of justice [ 23 , 51 , 52 ]. Some respondents in our study emphasized the need for parity between somatic and psychiatric illnesses, recognizing that there should be no distinction between patients suffering from either. They argued that upholding the principle of justice demands equal treatment and recognition of the suffering experienced by individuals with psychiatric illnesses.

However, for others, achieving justice requires acknowledging and addressing the unique challenges faced by patients predominantly suffering from psychiatric illnesses. A comprehensive and integrated healthcare approach is proposed, where mental health is regarded as an integral part of overall health. This approach involves allocating the same level of attention and resources to psychiatric medicine as given to somatic illnesses, aiming to combat stigma and discrimination towards individuals with psychiatric conditions. Equitable treatment during life and at the end of life becomes the focus.

Yet, the Belgian context of psychiatry presents significant challenges. The field is characterized by underfunding and fragmented care, particularly for individuals with longstanding and complex psychiatric problems [ 53 ]. Additionally, the end-of-life care for psychiatric patients is still underdeveloped, and palliative psychiatry is in its early stages, lacking a uniformly agreed-upon definition or clear implementation guidelines [ 54 ]. In response, Belgium is exploring the “Oyster Care” model, designed to provide flexible, personalized care for individuals with severe and persistent mental illness who may be at risk of neglect or overburdened by psychiatric services [ 55 ]. This model aims to create a safe “exoskeleton” or supportive environment for patients, recognizing that recovery, reintegration, and resocialization might not be attainable for everyone with certain psychiatric conditions [ 55 ].

However, the integration of Oyster Care in today’s psychiatric practice is still limited and requires further development. Emphasizing the value of justice calls for continued efforts to enhance and refine psychiatric care, ensuring that individuals with psychiatric illnesses receive equitable treatment throughout their lives, including end-of-life care decisions [ 55 , 56 ].

Implications for future research, policy, and practice

In terms of policy and practice, our findings indicate that the discourse surrounding euthanasia extends beyond legal or medical considerations and encompasses fundamental ethical values that underpin our society. These values may not always be aligned and can create ethical dilemmas that are challenging to address. A value-centred approach to the euthanasia debate necessitates a constructive ethical dialogue among various actors involved, including patients, healthcare practitioners, and the wider community. This conversation should strive to comprehend the diverse values involved and endeavour to achieve a balance between these values. Additionally, ethical dialogue might encourage individuals to reflect on their own assumptions and beliefs, leading to more informed and thoughtful decision-making on ethical and moral issues. Ultimately, ethical dialogue can promote a more just and equitable society that prioritizes empathy, understanding, and mutual respect.

It is also crucial to acknowledge that patients with somatic illnesses and those with psychiatric illnesses may have different needs and expectations regarding the end of life. Hence, end-of life healthcare must be sensitive to the unique needs of each group. This recognition of differences does not justify unequal treatment or discrimination based on the type of illness. Instead, it involves addressing the different needs and expectations of each patient group while ensuring equitable and high-quality care for all.

As regards research, most articles on euthanasia legislation to date placed the emphasis on what other countries and states can learn from the Belgian and Dutch euthanasia practice. In addition, what can be learned is mainly restricted to the evidence and reflections on factual issues from a global practical-clinical perspective. Consequently, one of the main ethical, clinical, and societal issues remains unrequited, namely the impact of legislation and its consequences on an intrapersonal, interpersonal, medical, social, and societal level. Although cultural diversity is recently put high on the research agenda concerning general health care and mental health care, it is largely understudied in the context of end-of-life decisions and largely ignored in the context of psychiatry. Fewer articles have focused on what the latter countries may learn from those not implementing or not considering euthanasia legislation. In an increasingly diverse society, rapidly evolving in terms of fluidity and multi-ethnicity, cross-cultural research can help us learn from one another. To address the many dimensions of euthanasia, there is a need for input from a variety of academic fields, including sociology, anthropology, communication studies, and history. Further interdisciplinary research in all these areas could help inform policy and practice related to euthanasia.

Strengths and limitations

This is the first empirical in-depth interview study that uncovered the underlying ethical considerations of a variety and relatively large sample of health care professionals and volunteers in Belgium, a country with one of the most permissive legislative frameworks regarding euthanasia, as – unlike in some other countries – it does not exclude adults with psychiatric conditions per definition. Belgium is also one of the pioneering countries with such a legislative framework and can boast on two decades of euthanasia legislation and implementation.

We succeeded in providing a unique and representative sample of participants, varying in gender, work setting and expertise, and stances regarding euthanasia. Finally, and unlike former scientific studies that focused on either the somatic or psychiatric context, we now gauged for participants’ ethical perspectives on euthanasia in both fields of medicine.

There are also several limitations to our study. We may have experienced selection bias, as our sample of non-physicians had varying ages, but the sample of physicians was mostly older than 60. In addition, some interviews had to be postponed or cancelled due to COVID-19 restrictions and, potentially, due to legal and emotional concerns surrounding a high-profile euthanasia case being brought to court. Additionally, our sample exhibited heterogeneity regarding worldview (religious or non-religious), but possibly not regarding other culture-sensitive aspects, like migration background. As our qualitative research focused on exploring themes, narratives, and shared experiences rather than on ensuring high participation rates for statistical generalizability, drawing definitive conclusions regarding the prevalence of each opinion (pro/ambivalent/critical/against), the level of experience, or perspective across the entire spectrum of euthanasia practice is beyond the scope of our study.

Finally, although there is a growing number of countries and states around the globe with a legislative framework on euthanasia, all the legal frameworks differ from one another, so the results of our study cannot be generalized to the specific euthanasia context in e.g., Switzerland or Canada.

Our study illuminates the foundational values guiding perceptions of euthanasia, including autonomy, compassion, quality care, and justice, which permeate through four interconnected tiers: the patient, their inner circle, the medical community, and society at large. Despite varied stances on euthanasia, participants demonstrated a convergence of ethical principles across these tiers, shaped by nuanced interpretations and considerations. While explicit discussions of distinct ethical values were infrequent, their profound impact on euthanasia perspectives underscores the importance of ethical discourse in navigating this complex issue. By fostering inclusive dialogue and reconciling diverse values, we can promote informed decision-making, justice, and empathy in end-of-life care, particularly in psychiatric settings. Interdisciplinary research is essential for a comprehensive understanding of euthanasia’s dimensions and to inform policy development. While our study is rooted in Belgium, its implications extend to the broader euthanasia discourse, suggesting avenues for further exploration and cross-cultural understanding.

Data availability

The datasets generated and/or analysed during the current study are not publicly available due reasons of privacy and anonymity, but are available from the corresponding author on reasonable request, following procedures from all 3 Medical Ethics Committees involved. To access the supplementary materials, see the Open Science Framework repository at https://osf.io/26gez/?view_only=af42caddb2554acfb7d1d5aabd4dec7a . Upon publication of this paper, the repository will be made public, and a shorter link will be provided.

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Acknowledgements

The authors wish to thank prof. dr. Kenneth Chambaere and prof. dr. Kurt Audenaert for their preliminary advice regarding the ethics of the research methodology, dr. Steven Vanderstichelen for his help with the interviews (i.e., conducting and transcribing) and all the participants for sharing their professional and in some cases also personal experiences during the interview. We’d also like to thank prof. dr. Kenneth Chambaere for the supervision during the conducting of the interviews and his feedback on the ‘near to final’ draft.

MV is funded by the Research Foundation Flanders via research project (G017818N) and PhD fellowship (1162618 N).

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The article has been developed with the following authors’ contributions: MV was responsible for the study methodology and managed ethical approval; MV conducted most of the interviews and wrote the main manuscript texts. AL drafted the ethical interpretation framework. MV, LM, KP and AL were responsible for the coding structure and data interpretation and performed a critical review and revision of the final manuscript.

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This research project was performed in accordance with the Declaration of Helsinki and the European rules of the General Data Protection Regulation. It received ethical approval from the Medical Ethics Committee of the Brussels University Hospital with reference BUN 143201939499, from the Medical Ethics Committee of Ghent University Hospital with reference 2019/0456, and from the Medical Ethics Committee of the Brothers of Charity with reference OG054-2019-20. The interviews were held after obtaining informed consent from all the participants.

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Verhofstadt, M., Moureau, L., Pardon, K. et al. Ethical perspectives regarding Euthanasia, including in the context of adult psychiatry: a qualitative interview study among healthcare workers in Belgium. BMC Med Ethics 25 , 60 (2024). https://doi.org/10.1186/s12910-024-01063-7

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Elektrostal is a vibrant city located in the Moscow Oblast region of Russia. With a rich history, stunning architecture, and a thriving community, Elektrostal is a city that has much to offer. Whether you are a history buff, nature enthusiast, or simply curious about different cultures, Elektrostal is sure to captivate you.

This article will provide you with 40 fascinating facts about Elektrostal, giving you a better understanding of why this city is worth exploring. From its origins as an industrial hub to its modern-day charm, we will delve into the various aspects that make Elektrostal a unique and must-visit destination.

So, join us as we uncover the hidden treasures of Elektrostal and discover what makes this city a true gem in the heart of Russia.

Key Takeaways:

• Elektrostal, known as the “Motor City of Russia,” is a vibrant and growing city with a rich industrial history, offering diverse cultural experiences and a strong commitment to environmental sustainability.
• With its convenient location near Moscow, Elektrostal provides a picturesque landscape, vibrant nightlife, and a range of recreational activities, making it an ideal destination for residents and visitors alike.

Known as the “Motor City of Russia.”

Elektrostal, a city located in the Moscow Oblast region of Russia, earned the nickname “Motor City” due to its significant involvement in the automotive industry.

Home to the Elektrostal Metallurgical Plant.

Elektrostal is renowned for its metallurgical plant, which has been producing high-quality steel and alloys since its establishment in 1916.

Boasts a rich industrial heritage.

Elektrostal has a long history of industrial development, contributing to the growth and progress of the region.

Founded in 1916.

The city of Elektrostal was founded in 1916 as a result of the construction of the Elektrostal Metallurgical Plant.

Located approximately 50 kilometers east of Moscow.

Elektrostal is situated in close proximity to the Russian capital, making it easily accessible for both residents and visitors.

Known for its vibrant cultural scene.

Elektrostal is home to several cultural institutions, including museums, theaters, and art galleries that showcase the city’s rich artistic heritage.

A popular destination for nature lovers.

Surrounded by picturesque landscapes and forests, Elektrostal offers ample opportunities for outdoor activities such as hiking, camping, and birdwatching.

Hosts the annual Elektrostal City Day celebrations.

Every year, Elektrostal organizes festive events and activities to celebrate its founding, bringing together residents and visitors in a spirit of unity and joy.

Has a population of approximately 160,000 people.

Elektrostal is home to a diverse and vibrant community of around 160,000 residents, contributing to its dynamic atmosphere.

Boasts excellent education facilities.

The city is known for its well-established educational institutions, providing quality education to students of all ages.

A center for scientific research and innovation.

Elektrostal serves as an important hub for scientific research, particularly in the fields of metallurgy , materials science, and engineering.

Surrounded by picturesque lakes.

The city is blessed with numerous beautiful lakes , offering scenic views and recreational opportunities for locals and visitors alike.

Well-connected transportation system.

Elektrostal benefits from an efficient transportation network, including highways, railways, and public transportation options, ensuring convenient travel within and beyond the city.

Famous for its traditional Russian cuisine.

Food enthusiasts can indulge in authentic Russian dishes at numerous restaurants and cafes scattered throughout Elektrostal.

Home to notable architectural landmarks.

Elektrostal boasts impressive architecture, including the Church of the Transfiguration of the Lord and the Elektrostal Palace of Culture.

Offers a wide range of recreational facilities.

Residents and visitors can enjoy various recreational activities, such as sports complexes, swimming pools, and fitness centers, enhancing the overall quality of life.

Provides a high standard of healthcare.

Elektrostal is equipped with modern medical facilities, ensuring residents have access to quality healthcare services.

Home to the Elektrostal History Museum.

The Elektrostal History Museum showcases the city’s fascinating past through exhibitions and displays.

A hub for sports enthusiasts.

Elektrostal is passionate about sports, with numerous stadiums, arenas, and sports clubs offering opportunities for athletes and spectators.

Celebrates diverse cultural festivals.

Throughout the year, Elektrostal hosts a variety of cultural festivals, celebrating different ethnicities, traditions, and art forms.

Electric power played a significant role in its early development.

Elektrostal owes its name and initial growth to the establishment of electric power stations and the utilization of electricity in the industrial sector.

Boasts a thriving economy.

The city’s strong industrial base, coupled with its strategic location near Moscow, has contributed to Elektrostal’s prosperous economic status.

Houses the Elektrostal Drama Theater.

The Elektrostal Drama Theater is a cultural centerpiece, attracting theater enthusiasts from far and wide.

Popular destination for winter sports.

Elektrostal’s proximity to ski resorts and winter sport facilities makes it a favorite destination for skiing, snowboarding, and other winter activities.

Promotes environmental sustainability.

Elektrostal prioritizes environmental protection and sustainability, implementing initiatives to reduce pollution and preserve natural resources.

Home to renowned educational institutions.

Elektrostal is known for its prestigious schools and universities, offering a wide range of academic programs to students.

Committed to cultural preservation.

The city values its cultural heritage and takes active steps to preserve and promote traditional customs, crafts, and arts.

Hosts an annual International Film Festival.

The Elektrostal International Film Festival attracts filmmakers and cinema enthusiasts from around the world, showcasing a diverse range of films.

Encourages entrepreneurship and innovation.

Elektrostal supports aspiring entrepreneurs and fosters a culture of innovation, providing opportunities for startups and business development.

Offers a range of housing options.

Elektrostal provides diverse housing options, including apartments, houses, and residential complexes, catering to different lifestyles and budgets.

Home to notable sports teams.

Elektrostal is proud of its sports legacy, with several successful sports teams competing at regional and national levels.

Boasts a vibrant nightlife scene.

Residents and visitors can enjoy a lively nightlife in Elektrostal, with numerous bars, clubs, and entertainment venues.

Promotes cultural exchange and international relations.

Elektrostal actively engages in international partnerships, cultural exchanges, and diplomatic collaborations to foster global connections.

Surrounded by beautiful nature reserves.

Nearby nature reserves, such as the Barybino Forest and Luchinskoye Lake, offer opportunities for nature enthusiasts to explore and appreciate the region’s biodiversity.

Commemorates historical events.

The city pays tribute to significant historical events through memorials, monuments, and exhibitions, ensuring the preservation of collective memory.

Promotes sports and youth development.

Elektrostal invests in sports infrastructure and programs to encourage youth participation, health, and physical fitness.

Hosts annual cultural and artistic festivals.

Throughout the year, Elektrostal celebrates its cultural diversity through festivals dedicated to music, dance, art, and theater.

Provides a picturesque landscape for photography enthusiasts.

The city’s scenic beauty, architectural landmarks, and natural surroundings make it a paradise for photographers.

Connects to Moscow via a direct train line.

The convenient train connection between Elektrostal and Moscow makes commuting between the two cities effortless.

A city with a bright future.

Elektrostal continues to grow and develop, aiming to become a model city in terms of infrastructure, sustainability, and quality of life for its residents.

In conclusion, Elektrostal is a fascinating city with a rich history and a vibrant present. From its origins as a center of steel production to its modern-day status as a hub for education and industry, Elektrostal has plenty to offer both residents and visitors. With its beautiful parks, cultural attractions, and proximity to Moscow, there is no shortage of things to see and do in this dynamic city. Whether you’re interested in exploring its historical landmarks, enjoying outdoor activities, or immersing yourself in the local culture, Elektrostal has something for everyone. So, next time you find yourself in the Moscow region, don’t miss the opportunity to discover the hidden gems of Elektrostal.

Q: What is the population of Elektrostal?

A: As of the latest data, the population of Elektrostal is approximately XXXX.

Q: How far is Elektrostal from Moscow?

A: Elektrostal is located approximately XX kilometers away from Moscow.

Q: Are there any famous landmarks in Elektrostal?

A: Yes, Elektrostal is home to several notable landmarks, including XXXX and XXXX.

Q: What industries are prominent in Elektrostal?

A: Elektrostal is known for its steel production industry and is also a center for engineering and manufacturing.

Q: Are there any universities or educational institutions in Elektrostal?

A: Yes, Elektrostal is home to XXXX University and several other educational institutions.

Q: What are some popular outdoor activities in Elektrostal?

A: Elektrostal offers several outdoor activities, such as hiking, cycling, and picnicking in its beautiful parks.

Q: Is Elektrostal well-connected in terms of transportation?

A: Yes, Elektrostal has good transportation links, including trains and buses, making it easily accessible from nearby cities.

Q: Are there any annual events or festivals in Elektrostal?

A: Yes, Elektrostal hosts various events and festivals throughout the year, including XXXX and XXXX.

Elektrostal's fascinating history, vibrant culture, and promising future make it a city worth exploring. For more captivating facts about cities around the world, discover the unique characteristics that define each city . Uncover the hidden gems of Moscow Oblast through our in-depth look at Kolomna. Lastly, dive into the rich industrial heritage of Teesside, a thriving industrial center with its own story to tell.

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