Opinions about euthanasia and advanced dementia: a qualitative study among Dutch physicians and members of the general public

BMC Medical Ethics

Ghislaine JMW van Thiel¹  Agnes van der Heide³  Heleen AM Weyers⁵  Nienke de Graeff¹  Suzanne van de Vathorst⁴  Donald G van Tol²  Judith AC Rietjens³  Johannes JM van Delden¹  Natasja JH Raijmakers³  Pauline SC Kouwenhoven¹ 

[1]Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Room number STR.5.133, P.O. Box 85500, 3508 GA, Internal post number STR.6.131 Utrecht, The Netherlands

[2]Department of General Practice, University Medical Center Groningen, Groningen, The Netherlands

[3]Department of Public Health, Erasmus Medical Center Rotterdam, Rotterdam, The Netherlands

[4]Department of Ethics and Philosophy of Medicine, Erasmus Medical Center Rotterdam, Rotterdam, The Netherlands

[5]Department of Legal Theory, University of Groningen, Groningen, The Netherlands

关键词: Law;    Ethics;    Public opinion;    End-of-life decisions;    Dementia;    Euthanasia;   

Others  :  1122037
DOI  :  10.1186/1472-6939-16-7

 received in 2014-03-22, accepted in 2015-01-02,  发布年份 2015

【 摘 要 】

Background

The Dutch law states that a physician may perform euthanasia according to a written advance euthanasia directive (AED) when a patient is incompetent as long as all legal criteria of due care are met. This may also hold for patients with advanced dementia. We investigated the differing opinions of physicians and members of the general public on the acceptability of euthanasia in patients with advanced dementia.

Methods

In this qualitative study, 16 medical specialists, 19 general practitioners, 16 elderly physicians and 16 members of the general public were interviewed and asked for their opinions about a vignette on euthanasia based on an AED in a patient with advanced dementia.

Results

Members of the general public perceived advanced dementia as a debilitating and degrading disease. Physicians emphasized the need for direct communication with the patient when making decisions about euthanasia. Respondent from both groups acknowledged difficulties in the assessment of patients’ autonomous wishes and the unbearableness of their suffering.

Conclusion

Legally, an AED may replace direct communication with patients about their request for euthanasia. In practice, physicians are reluctant to forego adequate verbal communication with the patient because they wish to verify the voluntariness of patients’ request and the unbearableness of suffering. For this reason, the applicability of AEDs in advanced dementia seems limited.

【 授权许可】

   
2015 Kouwenhoven et al.; licensee BioMed Central.

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