Table 3 The interpretive value of intercoder disagreement and the ‘emotional elephant in the room’

Situation BR and CL both analyzed a transcript of a bereaved relative whose incurably ill parent had received euthanasia at home just four days after the patient had been discharged from the hospital because clinical specialists had concluded that there were no life-prolonging treatments left. The relative’s story spoke of a rapid physical decline in combination with a long-lasting wish for euthanasia, and agreement about that wish amongst the patient and family. While comparing our analyses, we noticed that there was agreement to a large extent in cycle 1 (in vivo codes), cycle 3 (context) and most items in cycle 2 (narrative features), although BR had jotted down more details. However, intercoder disagreement existed over the question ‘How does it feel?’ (mood, tone). Here are the answers to this question that CL and BR jotted down:

 BR: Tone of disbelief. Perplexity. Laughs often but seems discordant with content of interview (comments in fieldnotes written after the interview: heaviness of everything that happened stood out. Element of surprise despite knowing what to expect)

 CL: As if it all has been arranged very well, pragmatic stance of those involved, matter-of-fact approach

Reflection Together we examined possible explanations for the differences in perception. First, we realized that emotions easily get ‘lost in transcription’. While the interviewer (BR) sensed a perplexity and emotional gravity of the story during the interview, this couldn’t be read by CL from the transcript (despite the mentioning of non-verbal utterances). Second, we hypothesized that both interpretations may be valid, reflecting the idea of ‘tolerating uncertainty and ambiguity’. Maybe the experience was indeed ambiguous, both well-arranged given the circumstances and emotionally taxing, being remembered with both pragmatism and perplexity. Third, the different interpretations compelled both researchers to scrutinize their own perceptions: was BR (as a MD) perplexed because of this story about a ‘speedy-euthanasia’? Did CL (not being an MD) miss the impact of this speediness because he did not identify with the physician who performed euthanasia, and was more focused on the relief expressed by the interviewee? It may be counterintuitive in science—especially from a positivist perspective with its push towards objectivity—to pose the question ‘How does this feel?’, but the question yielded valuable insights about the role of emotions, rational thinking and the person of the researcher/care-professional in conversations about euthanasia