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Requests for euthanasia and physician-assisted suicide and the availability and application of palliative options

Published online by Cambridge University Press:  25 October 2006

MARIJKE C. JANSEN-VAN DER WEIDE, ,
BREGJE D. ONWUTEAKA-PHILIPSEN  and
GERRIT VAN DER WAL
MARIJKE C. JANSEN-VAN DER WEIDE,
Affiliation:
Department of Public and Occupational Health and Institute for Research in Extramural Medicine, VU University Medical Center, Amsterdam, The Netherlands
BREGJE D. ONWUTEAKA-PHILIPSEN
Affiliation:
Department of Public and Occupational Health and Institute for Research in Extramural Medicine, VU University Medical Center, Amsterdam, The Netherlands
GERRIT VAN DER WAL
Affiliation:
Department of Public and Occupational Health and Institute for Research in Extramural Medicine, VU University Medical Center, Amsterdam, The Netherlands
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Abstract

Objective: This study investigated the palliative options available when a patient requested euthanasia or physician-assisted suicide (EAS), the extent to which the options were applied, and changes in the patient's wishes.

Methods: In an observational study, 3614 general practitioners (GPs) filled in a questionnaire and described their most recent request for EAS (if any) (n = 1,681).

Results: Palliative options were still available in 25% of cases. In these cases options were applied in 63%; in 46% of these cases patients withdrew their request. Medication other than antibiotics, which was most frequently mentioned as a palliative option (67%), and applied most frequently (79%), together with radiotherapy, most frequently resulted in patients withdrawing their request.

Significance of results: GPs include the availability of palliative options in their decision making when considering EAS. The fact that not all options are applied or, if applied, the patient persists in the request is related to autonomy of the patient, the burden on the patient, and medical futility of the option.

Keywords

EuthanasiaPhysician-assisted suicidePalliative careDecision making
Type
Research Article
Information
Palliative & Supportive Care , Volume 4 , Issue 4 , December 2006 , pp. 399 - 406
Copyright
© 2006 Cambridge University Press

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References

REFERENCES

Billings, J.A. (2000). Palliative care, recent advances. British Medical Journal, 321, 555.Google Scholar
Board of the Royal Dutch Medical Association (1995). Vision on euthanasia. Utrecht: Author (in Dutch).
Board of the Royal Dutch Medical Association. (2003). Vision on euthanasia. Utrecht: Author (in Dutch).
Davies, J. & McVicar, A. (2000). Balancing efficiency, cost-effectiveness and patient choice in opioid selection. International Journal of Palliative Nursing, 6, 470–478.Google Scholar
Greenstreet, W. (2001). The concept of total pain: A focused patient case study. British Journal of Nursing, 6, 470–478.Google Scholar
Hearn, J. & Higginson, I.J. (1998). Do specialist palliative care teams improve outcomes for cancer patients? A systematic literature review. Palliative Medicine, 12, 17–22.Google Scholar
Hedberg, K., Hopkins, D., & Southwick, K. (2002). Legalized physician-assisted suicide in Oregon, 2001. New England Journal of Medicine, 346, 450–452.Google Scholar
Jansen-van der Weide, M.C., Onwuteaka-Philipsen, B.D., & van der Wal, G. (2004). Implementation of the project ‘Support and Consultation on Euthanasia in the Netherlands’ (SCEN). Health Policy, 69, 365–373.Google Scholar
Jansen-van der Weide, M.C., Onwuteaka-Philipsen, B.D., & van der Wal, G. (2005). Granted, undecided, withdrawn and refused requests for euthanasia and physician-assisted suicide. Archives of Internal Medicine, 165, 1698–1704.Google Scholar
Klinkenberg, M.L., Willems, D.L., van der Wal, G., et al. (2004). Symptom burden in the last phase of life. Journal of Pain and Symptom Management, 27, 5–13.Google Scholar
Kuin, A., Courtens, M.A., Deliens, L., et al. (2004). Palliative care consultation in The Netherlands: A nationwide evaluation study. Journal of Pain and Symptom Management, 27, 53–60.Google Scholar
Lobchuk, M.M., Kristjanson, L., Degner, L., et al. (1997). Perceptions of symptom distress in lung cancer patients: I. Congruence between patients and primary care givers. Journal of Pain and Symptom Management, 14, 136–146.Google Scholar
Löfmark, R., Mortier, F., Nilstun, T., et al. (2006). Palliative care training and experiences in end-of-life care: A survey among physicians in Australia and Europe. Journal of Palliative Care, 22, 105–110.Google Scholar
McCann, R.M. (1994). Comfort care for terminally ill patients. The appropriate use of nutrition and hydration. Journal of the American Medical Association, 272, 1263–1266.Google Scholar
Nelson, K.A., Walsh, D., Behrens, C., et al. (2000). The dying cancer patient. Seminars in Oncology, 27, 84–89.Google Scholar
Onwuteaka-Philipsen, B.D., van der Heide, A., Koper, D., et al. (2003). Euthanasia and other end-of life decisions in the Netherlands in 1990, 1995, and 2001. Lancet, 362, 395–399.Google Scholar
Quill, T.E., Coombs Lee, B., & Nunn, S. (2000). Palliative treatments of last resort: Choosing the least harmful alternative. Annals of Internal Medicine, 132, 488–493.Google Scholar
Rousseau, P. (1996). Nonpain symptom management in terminal care. Clinics in Geriatric Medicine, 2, 313–327.Google Scholar
Sullivan, A.D., Hedberg, K., & Fleming, D.W. (2000). Legalized physician-assisted suicide in Oregon: The second year. New England Journal of Medicine, 342, 598–604.Google Scholar
The SUPPORT Principal Investigators. (1995). A controlled trial to improve care for seriously ill hospitalized patients. The study to understand prognoses and preferences for outcomes and risks for treatment (SUPPORT). Journal of the American Medical Association, 74, 1591–1598.Google Scholar