Euthanasia in advanced dementia; the view of the general practitioners in the Netherlands on a vignette case along the juridical and ethical dispute

BMC Family Practice

Boudewijn Chabot¹  Jaap Schuurmans¹  Marcel Olde Rikkert²  Chantalle Crol²  Yvonne Engels² 

[1]General practice Ottenhoff, B. Ottenhoffstraat 18, 6561 CM, Groesbeek, The Netherlands

[2]Radboud University Medical Center, Postbox 9101, 6500 HB, Nijmegen, The Netherlands

关键词: Euthanasia;    Dementia;    General practitioners;    Support;    Burden;    Jurisdiction;    Human rights;    Ethical implications;   

DOI  :  10.1186/s12875-021-01580-z

来源: Springer

【 摘 要 】

BackgroundIn the Netherlands, euthanasia has been regulated by law since 2002. In the past decade, a growing number of persons with dementia requested for euthanasia, and more requests were granted. A euthanasia request from a patient with advanced dementia (PWAD) can have a major impact on a general practitioner (GP). We aimed to get insights in the views of Dutch GPs on euthanasia concerning this patient group.MethodsA postal survey was sent to 894 Dutch GPs. Questions were asked about a case vignette about a PWAD who was not able to confirm previous wishes anymore. Quantitative data were analyzed with descriptive statistics.ResultsOf the 894 GPs approached, 422 (47.3%) completed the survey. One hundred seventy-eight GPs (42.2%) did not agree with the statement that an Advance Euthanasia Directive (AED) can replace an oral request if communication with the patient concerned has become impossible. About half of the respondents (209; 49.5%) did not agree that the family can initiate a euthanasia trajectory, 95 GPs (22.5%) would accept such a family initiative and 110 GPs (26.1%) would under certain conditions.DiscussionIn case of a PWAD, when confirming previous wishes is not possible anymore, about half of the Dutch GPs would not accept an AED to replace verbal or non-verbal conformation nor consider performing euthanasia; a minority would. Our study shows that, probably due to the public debate and changed professional guidelines, conflicting views have arisen among Dutch GPs about interpretation of moral, ethical values considering AED and PWADs.

【 授权许可】

CC BY