Drugs Used for Euthanasia: A Repeated Population-Based Mortality Follow-Back Study in Flanders, Belgium, 1998–2013

Dierickx, Sigrid; Cohen, Joachim; Stichele, Robert Vander; Deliëns, Luc; Chambaere, Kenneth

doi:10.1016/j.jpainsymman.2018.06.015

Cited by 10 publications

(6 citation statements)

References 34 publications

(24 reference statements)

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“…It is important to note that research in Belgium and the Netherlands has shown that not all cases of euthanasia and assisted death are reported so these figures are likely underestimations of the actual extent of the practices (7). Some physicians who administer opiates with the intention of ending a person's life at their request do not recognize their actions as euthanasia, and in other cases physicians do not want to follow the prescribed procedures using recommended medication because their patient does not satisfy all the required conditions or because they find the procedure overly cumbersome (29).…”

Section: Mortality Follow-back Studies Among Attending Physiciansmentioning

confidence: 99%

“…The clinician is often not present when the patient administers the life-ending drugs in the US, usually by swallowing a lethal cocktail, however, in Belgium, the Netherlands and Luxembourg, physician presence is mandatory (5). The Dutch Medical Association has published guidelines on recommended and non-recommended drugs making it part of the professional conduct rules (29). In Belgium, pharmacists have published guidance on specific products and dosages and best practice information has been disseminated by the Life End Information Forum (LEIF) in Flanders, the Dutch-speaking part of Belgium (29).…”

Section: Drugs Used For Euthanasia and Assisted Suicidementioning

confidence: 99%

“…The Dutch Medical Association has published guidelines on recommended and non-recommended drugs making it part of the professional conduct rules (29). In Belgium, pharmacists have published guidance on specific products and dosages and best practice information has been disseminated by the Life End Information Forum (LEIF) in Flanders, the Dutch-speaking part of Belgium (29). The drugs most commonly used for physician-assisted suicide include a self-administered barbiturate to induce unconsciousness after which death results slowly from asphyxia due to cardiorespiratory depression (34).…”

Section: Drugs Used For Euthanasia and Assisted Suicidementioning

confidence: 99%

See 2 more Smart Citations

Assisted dying around the world: a status quaestionis

Mroz¹,

Dierickx²,

Deliëns³

et al. 2021

Ann Palliat Med

Self Cite

118

120

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Assisted dying practices, which include euthanasia and physician-assisted suicide (PAS), have expanded significantly around the world over the past 20 years. Euthanasia refers to the act of intentionally ending the life of a patient by a health care practitioner through medical means at that patient's explicit request while PAS involves the provision or prescribing of drugs by a health care practitioner for a patient to end their own life. The growing global aging population accompanied by higher levels of chronic disease and protracted illnesses have sharpened the focus on end of life issues and societal and legislative debates continue to address related moral and ethical complexities. Assisted dying practices are now legal in 18 jurisdictions, increasing the number of people with access to euthanasia and/or physician-assisted suicide (PAS) to over 200 million. New legislation is being crafted or considered in Portugal, Spain and 16 US states. Germany has recently overturned a ban on assisted dying services and New Zealand will put legalization of euthanasia to a vote in 2020. Assisted dying practice characteristics differ and there is also considerable variation in the terminology and labels used for assisted dying, which can add to the confusion and controversy around the practices. Frequency of use also varies greatly by jurisdiction, though a consistent increase has been seen in European countries including Belgium, the Netherlands and Switzerland as well as some jurisdictions with long-standing physician assisted dying laws, such as Oregon and Washington. All assisted dying legislation includes substantive and procedural requirements, such as minimum age, waiting period, health condition, physician consultation and reporting procedure, however, some are extensive and detailed while others are more limited. As access to assisted dying expands in new and existing jurisdictions, research must also expand to diligently examine the impact on patients, specifically among vulnerable populations, as well as on health care practitioners, health care systems and communities. This article will provide a thorough investigation, or 'status quaestionis' of the terminology, evolution and current legislative picture of assisted dying practices around the globe and contribute to the ongoing ethical, regulatory and practice debate, which have become increasingly important considerations for medical practice, end-of-life care and public health.

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Section: Mortality Follow-back Studies Among Attending Physiciansmentioning

confidence: 99%

Section: Drugs Used For Euthanasia and Assisted Suicidementioning

confidence: 99%

Section: Drugs Used For Euthanasia and Assisted Suicidementioning

confidence: 99%

See 1 more Smart Citation

Assisted dying around the world: a status quaestionis

Mroz¹,

Dierickx²,

Deliëns³

et al. 2021

Ann Palliat Med

Self Cite

118

120

View full text Add to dashboard Cite

show abstract

“…Relevantly, research from Belgium found that despite AD being legal, some doctors who report that their primary intention is to hasten death still use medications associated with palliative sedation (morphine or other opioids and/or benzodiazepine) rather than recommended medications to hasten death, and that use of these medications is often termed by doctors there as 'palliative sedation' or 'alleviation of pain and symptoms'. 28…”

Section: Discussionmentioning

confidence: 99%

Intentional hastening of death through medication: a case series analysis of Victorian deaths prior to the Voluntary Assisted Dying Act 2017

Willmott

White

Feeney

et al. 2021

Internal Medicine Journal

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Background: Voluntary assisted dying is lawful in Victoria in limited circumstances and commences in Western Australia in mid-2021. There is evidence that in rare cases, unlawful assisted dying practices occur in Australia.Aims: To determine whether assisted dying practices occurred in Victoria in the 12 months prior to the commencement of the Voluntary Assisted Dying Act 2017 (Vic) ('VAD Act'), and to examine features of any identified cases.Methods: Exploratory case series of adult patients in Victoria who died between May 2018 and 18 June 2019 as a result of medication administered with the primary intention of hastening death. Cases were identified from a self-administered survey about medical end-of-life decisions for adult patients, completed by Victorian specialists treating adults at the end of life. We examined reported use of medication with the primary intention of hastening the patient's death; characteristics of assisted dying cases, including doctors' classification of such practices.Results: Nine cases met the inclusion criteria. Death did not occur immediately after providing medication with the intention of hastening death. In eight cases, it was framed as palliative or terminal sedation and/or continuous deep sedation. Most doctors used language that distanced their practices from assisted dying.Conclusions: Unlawful assisted dying practices seem to have occurred in a small number of deaths in Victoria prior to commencement of the VAD Act. These practices typically occurred within the context of palliative or terminal sedation and may be difficult to distinguish from lawful palliative care practice. Some survey responses possibly reflect ambiguity in doctors' intentions when providing medication.

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“…One major caveat of studying MAiD practice through the reported cases is that it suffers from an under-reporting bias. Studies have estimated that, even several years after legalisation, from 1/5 (the Netherlands)4 to 1/3 (Belgium)5 cases is not reported. Hence, the advice is that this type of research should be combined with other forms of research indicated under the other recommendations.…”

Section: Study the Reported Cases In All Jurisdictions Where Maid mentioning

confidence: 99%