Intentionally ending one's own life in the presence or absence of a medical condition: A nationwide mortality follow-back study

Hagens, Martijn; Pasman, H. Roeline W.; Heide, Agnes van der

doi:10.1016/j.ssmph.2021.100871

Cited by 3 publications

(6 citation statements)

References 19 publications

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“…Voluntarily Stopping Eating and Drinking (VSED) is an important alternative to MAID. This is perhaps best illustrated by the documented experience in the Netherlands (38), where nearly 2% of all deaths are from VSED, half the rate of deaths from MAID. These patients can take food and fluid by mouth, but they make a voluntary, deliberate decision to stop, causing their death from dehydration (3).…”

Section: Advance Directives For Stopping Eating and Drinkingmentioning

confidence: 98%

Medical Aid in Dying and Dementia Directives

Pope

2021

bioethics

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Section: Advance Directives For Stopping Eating and Drinkingmentioning

confidence: 98%

Medical Aid in Dying and Dementia Directives

Pope

2021

bioethics

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“…Because we included patients with unsuccessful VSED attempts and even some who never initiated VSED, our sample captured patients who were not included in many previous studies. 1,3,4,6,20 In particular, these were often young psychiatric patients. 1,6 A Dutch study among people preparing for and seeking demedicalized assistance in suicide (for instance by VSED) included some psychiatric patients.…”

Section: Major Findingsmentioning

confidence: 99%

“…3 Studies from the Netherlands and Switzerland estimated 0.5% to 2.1% of people who die do so by VSED. [4][5][6] Patients do not need approval by their physician, or others, to start VSED. With adequate care, VSED can lead to a relatively comfortable death.…”

mentioning

confidence: 99%

“…According to professional standards, patients are entitled to care to relieve suffering during the process. 4 Caregivers can use guidance on care during VSED. In the Netherlands, physician-assisted dying (PAD) or euthanasia can be an alternative for patients with unbearable and incurable (physical or psychological) suffering; however, physicians can decline requests for PAD on personal grounds.…”

mentioning

confidence: 99%

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Patients Who Seek to Hasten Death by Voluntarily Stopping Eating and Drinking: A Qualitative Study

Bolt,

Pasman,

Onwuteaka-Philipsen

2023

Ann Fam Med

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PURPOSE Voluntary stopping of eating and drinking (VSED) is a controversial method to hasten death. Little is known about why and how people come to VSED. This study assessed patients' motives, how patients decide on VSED, and the ways in which they prepare for VSED and involve others. METHODSWe conducted a qualitative study in the Netherlands of 29 patients; 24 started VSED and 19 died. Thirteen patients were included before or during VSED and 16 afterward. We interviewed 17 patients, 18 relatives, and 10 professional caregivers. Inductive ideal-type analysis was used to describe typologies. RESULTSThree patient groups emerged. The first group (12 patients) were older people who felt life was completed, for whom control was important. They prepared well for VSED, but could overlook the need for help and the emotional burden their decision could place on relatives. The second group (11 patients) were older care-dependent patients with a poor quality of life. They sometimes started VSED suddenly, and they relied heavily on (informal) caregivers to prepare and execute their plan. The third group (6 patients) were psychiatric patients with a long-standing but fluctuating death wish, most of whom were younger. They often prepared for VSED in secrecy or started VSED unprepared.CONCLUSIONS Patients embarking on a trajectory toward VSED are a very diverse group, with different care needs. Guidance for care during VSED needs to be applicable to all 3 groups.

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“…In the Netherlands, assisting in suicide is forbidden and punishable for anyone but doctors, for whom such assistance is regulated by the Termination of Life and Assisted Suicide (review procedures) Act, which came into force in 2002 6 7. However, there are also individuals who wish to intentionally end their life without a physician’s help 8. In 2007, Chabot published a study into what he called ‘auto-euthanasia’: a form of life termination in which an individual independently ends his own life in dialogue with one or more confidants, but without a physician performing a lethal act 9.…”

Section: Introductionmentioning

confidence: 99%

Frequency of self-directed dying in the Netherlands: research protocol of a cross-sectional mixed-methods study

Bosma,

Stoppelenburg,

van der Heide

et al. 2024

BMJ Open

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IntroductionIn the Netherlands, assisting in suicide is allowed for physicians and regulated by the Termination of Life on Request and Assisted Suicide (review procedures) Act. However, some people decide to end their lives outside the medical domain, without a physician’s help. Two approaches for such self-directed dying are voluntary stopping eating and drinking (VSED) and independently taking lethal medication attended by a confidant (ILMC). The frequency of deaths by either of these methods in the Netherlands was examined in 2007. Since then, there have been societal, political and healthcare developments which may have had an influence on the frequency of self-directed dying. The primary objective of this study is to estimate how many people in the Netherlands currently die by VSED or ILMC. Secondary objectives include providing insight in the characteristics and quality of dying of people who choose for self-directed dying.Methods and analysisThis cross-sectional study consists of an online questionnaire study (January to February 2024) among a randomly drawn sample (n=37 500) from a representative panel of the Dutch adult population in which participants are asked about potential experiences of close relatives choosing for VSED or ILMC. A two-stage screening procedure will be used to determine whether the respondents’ experiences represent a death by VSED or ILMC. Additional interviews (n=40) will be held with questionnaire respondents indicating their willingness to participate (May to September 2024). Quantitative data will be analysed using SPSS software, and qualitative data will be thematically analysed using NVivo software.Ethics and disseminationThe study obtained approval from the Medical Research Ethics Committee of the Erasmus Medical Center, under number MEC-2023-0689. Informed consent will be sought from study participants in line with General Data Protection Regulation legislation. Results of the study will be disseminated through publications in scientific journals and conference presentations.Trial registration numberNCT06186791.

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Intentionally ending one's own life in the presence or absence of a medical condition: A nationwide mortality follow-back study

Cited by 3 publications

References 19 publications

Medical Aid in Dying and Dementia Directives

Medical Aid in Dying and Dementia Directives

Patients Who Seek to Hasten Death by Voluntarily Stopping Eating and Drinking: A Qualitative Study

Frequency of self-directed dying in the Netherlands: research protocol of a cross-sectional mixed-methods study

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