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Previous Volume 356:1957-1965 May 10, 2007 Number 19 Next

	Full Text PDF PDA Full Text PowerPoint Slide Set Supplementary Material Perspective by Quill, T. E. Add to Personal Archive Add to Citation Manager Notify a Friend E-mail When Cited E-mail When Letters Appear PubMed Citation

ABSTRACT

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.

Source Information

From Erasmus Medical Center, Rotterdam (A.H., H.M.B., J.A.C.R., P.J.M.); Vrije Universiteit Medical Center, Amsterdam (B.D.O.-P., M.L.R., J.E.H.-W., H.R.W.P., G.W.); University Medical Center, Utrecht (J.J.M.D.); Academic Medical Center, Amsterdam (A.G.J.M.J., J.K.M.G.); and Statistics Netherlands, Voorburg (C.J.M.P., I.M.D.) — all in the Netherlands.

Address reprint requests to Dr. van der Heide at the Department of Public Health, Erasmus Medical Center, P.O. Box 2040, 3000 CA Rotterdam, the Netherlands, or at a.vanderheide{at}erasmusmc.nl.

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