Belgium: Euthanasia and the use of end-of-life drugs without explicit request

Description: [of the article from Science Centric]

Despite fears to the contrary, the use of drugs to end life without patient request has not increased since euthanasia was legalised in Belgium, states an article in CMAJ (Canadian Medical Association.)

Euthanasia and physician-assisted suicide are controversial issues in the medical world. There are fears that the legalisation of euthanasia will result in an increase in the use of life-ending drugs without explicit patient request, especially for vulnerable people such as seniors.


Later, the report says:
Despite the lack of explicit patient request, the use of life-ending drugs was in most cases discussed with patients' families and health professional colleagues.

'The use of life-ending drugs without explicit patient request occurs predominantly in hospital and among elderly patients who are mostly in an irreversible coma or demented,' write Dr Kenneth Chambaere, Vrije Universiteit, Brussel, and coauthors. 'This fits the description of 'vulnerable' patient groups at risk of life-ending without request. Due attention should therefore be paid to protecting these particular patient groups from such practices. However, these patients are not proportionally more at risk than other patient groups.'


[There is information in the Notes section below.]
[There are other related stories in the Links section below.]

Links:

To read the full article click on one of these links, both of which go to the same destination. A short link is provided for the convenience of readers. Also, readers may search and browse past and future advisories on the web (see bottom.)

  • http://tinyurl.com/33cgtsd

  • http://www.sciencecentric.com/news/article.php?q=10051856-euthanasia-the-use-end-of-life-drugs-without-explicit-request

    Also see:

  • Physician-assisted deaths under the euthanasia law in Belgium [Canadian Medical Association Journal]
    http://www.cmaj.ca/cgi/doi/10.1503/cmaj.091876
    From the abstract:

    Methods: We mailed a questionnaire regarding the use of life-ending drugs with or without explicit patient request to physicians who certified a representative sample (n = 6927) of death certificates of patients who died in Flanders between June and November 2007.

    Results: The response rate was 58.4%. Overall, 208 deaths involving the use of life-ending drugs were reported: 142 (weighted prevalence 2.0%) were with an explicit patient request (euthanasia or assisted suicide) and 66 (weighted prevalence 1.8%) were without an explicit request. Euthanasia and assisted suicide mostly involved patients less than 80 years of age, those with cancer and those dying at home. Use of life-ending drugs without an explicit request mostly involved patients 80 years of older, those with a disease other than cancer and those in hospital. Of the deaths without an explicit request, the decision was not discussed with the patient in 77.9% of cases. Compared with assisted deaths with the patient's explicit re quest, those without an explicit request were more likely to have a shorter length of treatment of the terminal illness, to have cure as a goal of treatment in the last week, to have a shorter estimated time by which life was shortened and to involve the administration of opioids.


    The full 7 page document is available as a PDF document from this page.

  • The role of nurses in physician-assisted deaths in Belgium [Canadian Medical Association Journal]
    http://www.cmaj.ca/cgi/doi/10.1503/cmaj.091881
    From the abstract:

    Background: Belgium's law on euthanasia allows only physicians to perform the act. We investigated the involvement of nurses in the decision-making and in the preparation and administration of life-ending drugs with a patient's explicit request (euthanasia) or without an explicit request. We also examined factors associated with these deaths.

    Methods: In 2007, we surveyed 1678 nurses who, in an earlier survey, had reported caring for one or more patients who received a potential life-ending decision within the year before the survey. Eligible nurses were surveyed about their most recent case.

    Results: The response rate was 76%. Overall, 128 nurses reported having cared for a patient who received euthanasia and 120 for a patient who received life-ending drugs without his or her explicit request. Respectively, 64% (75/117) and 69% (81/118) of these nurses were involved in the physician's decision-making process. More often this entailed an ex change of information on the patient's condition or the patient's or relatives' wishes (45% [34/117] and 51% [41/118]) than sharing in the decision-making (24% [18/117] and 31% [25/118]). The life-ending drugs were administered by the nurse in 12% of the cases of euthanasia, as compared with 45% of the cases of assisted death without an explicit re quest. In both types of assisted death, the nurses acted on the physician's orders but mostly in the physician's absence. Factors significantly associated with a nurse administering the life- ending drugs included being a male nurse working in a hospital (odds ratio [OR] 40.07, 95% confidence interval [CI] 7.37-217.79) and the patient being over 80 years old (OR 5.57, 95% CI 1.98-15.70).

    Interpretation: By administering the life-ending drugs in some of the cases of euthanasia, and in almost half of the cases without an explicit request from the patient, the nurses in our study operated beyond the legal margins of their profession.


    The full 6 page document is available from this page in PDF format.

Source:

"Euthanasia and the use of end-of-life drugs without explicit request". Science Centric. 18 May 2010 20:12 GMT. <www.sciencecentric.com/news/article.php?q=10051856-euthanasia-the-use-end-of-life-drugs-without-explicit-request>. Science Centric, 81 Lyuben Karavelov Street, Sofia 1000, Bulgaria

Tags:

Tags (or keywords) briefly indicate some major topics of the report.

  • euthanasia

  • involuntary euthanasia

  • doctor

  • nurses

  • Belgium

Notes:
  • Ireland: Exit International to set up Irish group [sbpost.ie]
    http://www.sbpost.ie/news/ireland/euthanasia-body-to-set-up-irish-group-49289.html
    Exit International, the controversial pro-euthanasia organisation, is setting up a group in Ireland. The first advocacy group of its kind in Ireland will be headed by Dublin man Tom Curran. Curran said the association in Ireland would be a source of information and support to people interested in learning more about euthanasia and assisted suicide. He said people had a right to access information.

    Curran's partner had multiple sclerosis and, as her condition had become progressively worse, he said they had discussed options such as assisted suicide and euthanasia. Curran said the group was very much in its infancy, but planned to hold its first meeting before the end of July. He said he became involved with Exit International after attending a meeting held by Dr Philip Nitschke, its founder.

ID:

The EuthaNEWSia ID for this advisory is: enid201005199318.
Mailed: Wednesday, May 19, 2010 14:25:58 -0600
at Saskatoon, Saskatchewan.

Etcetera:

EuthaNEWSia is a free Canadian news advisory service covering end-of-life issues such as right to die, assisted suicide, and euthanasia. EuthaNEWSia is produced by the Right to Die Society of Canada which works toward a good death for all, including open, regulated and equitable access to euthanasia and assisted suicide. The editor is Michael Dawson <editor@euthanewsia.ca>.

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