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Previous Volume 346:1638-1644 May 23, 2002 Number 21 Next

	Full Text PDF PDA Full Text Editorial by Ganzini, L. Letters Add to Personal Archive Add to Citation Manager Notify a Friend E-mail When Cited PubMed Citation

ABSTRACT

Background Amyotrophic lateral sclerosis (ALS) is a disease that causes progressive paralysis leading to respiratory failure. Patients with ALS may consider physician-assisted suicide. However, it is not known how many patients, if given the option, would actually decide to end their lives by physician-assisted suicide or euthanasia nor at what stage of the disease they would choose to do so.

Methods We identified physicians of 279 patients in the Netherlands with a diagnosis of ALS who died between 1994 and 1999. Physicians were asked to fill out a validated questionnaire about the end-of-life decisions that were made. Of 241 eligible physicians, 203 returned the questionnaire (84 percent).

Results Of the 203 patients, 35 (17 percent) chose euthanasia and died that way. An additional six patients (3 percent) died as a result of physician-assisted suicide. Patients to whom religion was important were less likely to have died as a result of euthanasia or physician-assisted suicide. The choice of euthanasia or physician-assisted suicide was not associated with any particular characteristics of the disease or of the patient's care, nor was it associated with income or educational level. Disability before death was significantly more severe in patients who died as a result of euthanasia than among those who died in other ways. Physician-assisted suicide appeared to occur somewhat earlier in the course of the disease than did euthanasia. An additional 48 patients (24 percent) received palliative treatment, which probably shortened their lives.

Conclusions In the Netherlands, we found that one in five patients with ALS died as a result of euthanasia or physician-assisted suicide.

Source Information

From the Department of Neurology, University Medical Center, Utrecht, the Netherlands (J.H.V., J.H.J.W., L.H.B.); and the Department of Social Medicine and the Institute for Research in Extramural Medicine, Vrije Universiteit Medical Center (G.W.), and the Department of Neurology, Academic Medical Center (J.M.B.V.J.) — both in Amsterdam.

Address reprint requests to Dr. van den Berg at the Department of Neurology, G.03.228, University Medical Center Utrecht, P.O. Box 85500, 3508 GA Utrecht, the Netherlands, or at l.h.vandenberg{at}neuro.azu.nl.

Full Text of this Article

Related Letters:

Physician-Assisted Death
Jennekens F. G.I., Kater L., Leeman C. P., Druck P., Veldink J. H., van den Berg L. H., van der Wal G., Ganzini L., Block S.
Extract | Full Text | PDF  
N Engl J Med 2002; 347:1041-1043, Sep 26, 2002. Correspondence

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