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Twenty-five years requests for euthanasia and physician-assisted suicide in Dutch general practice.
Marquet, R.L., Visser, G.J., Spreeuwenberg, P., Peters, L., Bartelds, A. Twenty-five years requests for euthanasia and physician-assisted suicide in Dutch general practice. European Journal of Public Health: 2003, 13(4 sup) 71. Abstract.11th Annual Eupha Meeting 'Globalisation and Health in Europe: Harmonising Public Health Practices'. Rome, Italy, 20-22 November 2003.
Background: World-wide there is a great deal of interest in Dutch policy on euthanasia (E) and physician-assisted suicide (PAS). Apart from appreciation there is also concern that the increasing acceptance of E/PAS might lead to an ever growing number of requests for help to implement E/PAS. Methods: Personal interviews were held with a stratified sample of general practitioners, clinical specialists and nursing-home physicians (n=410; response 85%). Terminal sedation was defined as the combination of administering drugs in order to keep the patient continuously in deep sedation or coma until death, without giving artificial nutrition or hydration. Results: Terminal sedation is practised in about 10% of all deaths in the Netherlands in 2001. The most frequently mentioned reasons to apply terminal sedation were alleviation of pain (54%), restlessness (43%) and dyspnea (30%). The decision to apply deep sedation was Methods: Requests for E/PAS by terminally ill patients were registered from 1977-2001 by 62 GPs participating in the Dutch Sentinel Practice Network, representing about 1% of the Dutch population. Reasons for requests, nature of underlying disease and presence of a living will were also registered. Results: On average, GPs received 2,6 requests/year per 10.000 patients. The mean age of men was 67 years, of woman 68 years. Most patients (84%) were nursed at home, 55% had stated a wish for E/PAS in a living will. Most patients (75%) suffered from cancer. Pain, deterioration, hopelessness and severe dyspnea were major reasons for requesting E/PAS. Trends: the number of requests rose sharply in the first 10 years of registration, but stabilised from 1990 onwards. A slight decrease was noticed in the last 2 years. The mean proportion of PAS was 15%, it diminished to about 4% in the last 5 years. The percentage of patients with cancer and having a living will increased steadily during the years. Pain did become less important but (fear of) deterioration became a more important reason for requesting E/PAS.
Conclusions: After a sharp increase in the first decade of registration the number of requests stabilised. This trend is remarkable and supports the notion that in a country where everyone has access to health care there is no reason to fear that gradual liberalisation of the law leads to ever increasing requests for E/PAS.(aut. ref.)
Conclusions: After a sharp increase in the first decade of registration the number of requests stabilised. This trend is remarkable and supports the notion that in a country where everyone has access to health care there is no reason to fear that gradual liberalisation of the law leads to ever increasing requests for E/PAS.(aut. ref.)
Background: World-wide there is a great deal of interest in Dutch policy on euthanasia (E) and physician-assisted suicide (PAS). Apart from appreciation there is also concern that the increasing acceptance of E/PAS might lead to an ever growing number of requests for help to implement E/PAS. Methods: Personal interviews were held with a stratified sample of general practitioners, clinical specialists and nursing-home physicians (n=410; response 85%). Terminal sedation was defined as the combination of administering drugs in order to keep the patient continuously in deep sedation or coma until death, without giving artificial nutrition or hydration. Results: Terminal sedation is practised in about 10% of all deaths in the Netherlands in 2001. The most frequently mentioned reasons to apply terminal sedation were alleviation of pain (54%), restlessness (43%) and dyspnea (30%). The decision to apply deep sedation was Methods: Requests for E/PAS by terminally ill patients were registered from 1977-2001 by 62 GPs participating in the Dutch Sentinel Practice Network, representing about 1% of the Dutch population. Reasons for requests, nature of underlying disease and presence of a living will were also registered. Results: On average, GPs received 2,6 requests/year per 10.000 patients. The mean age of men was 67 years, of woman 68 years. Most patients (84%) were nursed at home, 55% had stated a wish for E/PAS in a living will. Most patients (75%) suffered from cancer. Pain, deterioration, hopelessness and severe dyspnea were major reasons for requesting E/PAS. Trends: the number of requests rose sharply in the first 10 years of registration, but stabilised from 1990 onwards. A slight decrease was noticed in the last 2 years. The mean proportion of PAS was 15%, it diminished to about 4% in the last 5 years. The percentage of patients with cancer and having a living will increased steadily during the years. Pain did become less important but (fear of) deterioration became a more important reason for requesting E/PAS.
Conclusions: After a sharp increase in the first decade of registration the number of requests stabilised. This trend is remarkable and supports the notion that in a country where everyone has access to health care there is no reason to fear that gradual liberalisation of the law leads to ever increasing requests for E/PAS.(aut. ref.)
Conclusions: After a sharp increase in the first decade of registration the number of requests stabilised. This trend is remarkable and supports the notion that in a country where everyone has access to health care there is no reason to fear that gradual liberalisation of the law leads to ever increasing requests for E/PAS.(aut. ref.)