Public HealthEuthanasia and other end-of-life decisions in the Netherlands in 1990, 1995, and 2001
Section snippets
Physician interviews and death-certificate studies
We studied end-of-life decision-making practices and attitudes in 1990, 1995, and 2001. All studies consisted of physician interviews and death-certificate studies. Details of the 1990 and 1995 studies have been described elsewhere.1, 2, 3, 4, 5 The questions and study designs that were used to collect the data were identical in all years.
For the interview studies, we interviewed random samples of physicians stratified by specialty. We included family physicians, nursing-home physicians, and
Frequency of assisted deaths and end-of-life decisions
The total annual number of deaths in the Netherlands increased by 5·3% between 1990 and 1995, and by 3·5% between 1995 and 2001. The number of explicit requests for euthanasia or assisted suicide rose from 8900 in 1990 to 9700 in 1995, which is an increase of 9·0%. Between 1995 and 2001, the number remained stable at 9700 (table 1).
The death-certificate studies showed the rate of euthanasia increased from 1·7% of all deaths in 1990 to 2·4% in 1995, and further to 2·6% in 2001. In the interview
Physicians' attitudes to rights at end of life
Physicians' attitudes towards people's rights in end-of-life decision making have altered only slightly during the period 1990-2001. In 1990 and 1995, 64% of all physicians thought that people have the right to decide about their own life and death; in 2001 this proportion was slightly lower. Fewer than half thought that patients would be less inclined to ask for euthanasia if they knew that their physician is willing to perform it if needed. About a third thought that euthanasia could be
Changes over time
The rate of euthanasia and explicit requests by patients for physicians' assistance in dying in the Netherlands seems to have stabilised, and physicians seem to have become somewhat more restrictive in their use. Euthanasia remains mainly restricted to groups other than patients with cancer, people younger than 80 years, and patients cared for by family physicians, who were already frequently involved in 1990. The continuing debate on whether and when physician-assistance in dying may be
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