End-of-Life Practices in the Netherlands Under the Euthanasia Act
van der Heide, Agnes
Onwuteaka-Philipsen, Bregje D.
Rurup, Mette L.
Buiting, Hilde M.
van Delden, Johannes J.M.
Hanssen-de Wolf, Johanna E.
Janssen, Anke G.J.M.
Pasman, H. Roeline W.
Rietjens, Judith A.C.
Prins, Cornelis J.M.
Deerenberg, Ingeborg M.
Gevers, Joseph K.M.
van der Maas, Paul J.
van der Wal, Gerrit
New England Journal of Medicine 2007 May 10; 356(19): 1957-1965
BACKGROUND: In 2002, an act regulating the ending of life by a physician at the request of a patient with unbearable suffering came into effect in the Netherlands. In 2005, we performed a follow-up study of euthanasia, physician-assisted suicide, and other end-of-life practices. METHODS: We mailed questionnaires to physicians attending 6860 deaths that were identified from death certificates. The response rate was 77.8%. RESULTS: In 2005, of all deaths in the Netherlands, 1.7% were the result of euthanasia and 0.1% were the result of physician-assisted suicide. These percentages were significantly lower than those in 2001, when 2.6% of all deaths resulted from euthanasia and 0.2% from assisted suicide. Of all deaths, 0.4% were the result of the ending of life without an explicit request by the patient. Continuous deep sedation was used in conjunction with possible hastening of death in 7.1% of all deaths in 2005, significantly increased from 5.6% in 2001. In 73.9% of all cases of euthanasia or assisted suicide in 2005, life was ended with the use of neuromuscular relaxants or barbiturates; opioids were used in 16.2% of cases. In 2005, 80.2% of all cases of euthanasia or assisted suicide were reported. Physicians were most likely to report their end-of-life practices if they considered them to be an act of euthanasia or assisted suicide, which was rarely true when opioids were used. CONCLUSIONS: The Dutch Euthanasia Act was followed by a modest decrease in the rates of euthanasia and physician-assisted suicide. The decrease may have resulted from the increased application of other end-of-life care interventions, such as palliative sedation. Copyright 2007 Massachusetts Medical Society.
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Rurup, Mette L.; Buiting, Hilde M; Pasman, H. Roeline W.; van der Maas, Paul J.; van der Heide, Agnes; Onwuteaka-Philipsen, Bregje D. (2008-12)
Policy Statements and Practice Guidelines for Medical End-of-Life Decisions in Dutch Health Care Institutions: Developments in the Past Decade Pasman, H Roeline W; Wolf, Johanna E Hanssen-de; Hesselink, Berniek A M; van der Heide, Agnes; van der Wal, Gerrit; van der Maas, Paul J; Onwuteaka-Philipsen, Bregje D (2009-09)To describe the existence of policy statements on euthanasia and physician-assisted suicide (EAS) and practice guidelines for all medical end-of-life decisions in Dutch health care institutions in 2005, whether the existence ...
Onwuteaka-Philipsen, Bregje D.; van der Heide, Agnes; Koper, Dirk; Keij-Deerenberg, Ingeborg; Rietjens, Judith A.C.; Rurup, Mette L.; Vrakking, Astrid M.; Georges, Jean Jacques; Muller, Martien T.; van der Wal, Gerrit; van der Maas, Paul J. (2003-08-02)Empirical data on the rate of euthanasia, physician-assisted suicide, and other end-of-life decisions have greatly contributed to the debate about the role of such practices in modern health care. In the Netherlands, the ...