XML Feed for RxPG News   Add RxPG News Headlines to My Yahoo!   Javascript Syndication for RxPG News

Research Health World General
 
  Home
 
 Latest Research
 Cancer
 Psychiatry
 Genetics
 Surgery
 Aging
 Ophthalmology
 Gynaecology
 Neurosciences
 Pharmacology
 Cardiology
 Obstetrics
 Infectious Diseases
 Respiratory Medicine
 Pathology
 Endocrinology
 Immunology
 Nephrology
 Gastroenterology
 Biotechnology
 Radiology
 Dermatology
 Microbiology
 Haematology
 Dental
 ENT
 Environment
 Embryology
 Orthopedics
 Metabolism
 Anaethesia
 Paediatrics
 Public Health
 Urology
 Musculoskeletal
 Clinical Trials
 Physiology
 Biochemistry
 Cytology
 Traumatology
 Rheumatology
 
 Medical News
 Health
 Opinion
 Healthcare
 Professionals
 Launch
 Awards & Prizes
 
 Careers
 Medical
 Nursing
 Dental
 
 Special Topics
 Euthanasia
 Ethics
 Evolution
 Odd Medical News
 Feature
 
 World News
 Tsunami
 Epidemics
 Climate
 Business
Search

Last Updated: Aug 19th, 2006 - 22:18:38

Euthanasia Channel
subscribe to Euthanasia newsletter

Special Topics : Euthanasia

   DISCUSS   |   EMAIL   |   PRINT
Assessing physician compliance with the rules for euthanasia and assisted suicide
Aug 10, 2005, 13:04, Reviewed by: Dr.

"There must be limits and an effective way to police them. Yet it remains unclear that we know how to restrain these practices and assure physician reporting. The Dutch should be commended for wrestling with this problem. But even they may not have the answer to this immensely difficult question."

 
Physicians in the Netherlands rely on careful patient evaluations and official practice guidelines when considering patient requests for euthanasia and physician-assisted suicide (EAS), according to a study in the August 8/22 issue of the Archives of Internal Medicine, one of the JAMA/Archives journals.

In Oregon, Belgium and the Netherlands physicians are permitted to perform euthanasia or physician-assisted suicide if specific official requirements are met, according to background information in the article. Because of the complexity of an EAS request and decision, several types of situations can arise: the request can be granted and EAS performed, patients can die of natural causes before the performance of EAS or before the decision is made, the patient can withdraw the request or the request can be refused.

Marijke C. Jansen-van der Weide, M.Sc., of VU University Medical Center, Amsterdam, the Netherlands, and colleagues surveyed all general practitioners in 18 of 22 Dutch general practice districts. Physicians received a written questionnaire in which they were asked about the number of requests for EAS they had received in the last 12 months and how they had dealt with those requests. In addition, physicians were asked to describe in detail the most explicit request for EAS received in the last 18 months, including patient symptoms, the extent to which the patient's situation met the official requirements for accepted practice and the decision-making process.

A total of 3,614 general practitioners responded to the questionnaire (60 percent response rate). Forty-four percent of all explicit requests for EAS resulted in the granting and performance of EAS, the researchers report. The patient died before the performance of the request in 13 percent of cases, or before the final decision was made in 13 percent of cases. The patient withdrew the request in 13 percent of cases and the physician refused the request 12 percent of the time. The most frequent reasons for requesting EAS were "pointless suffering," "loss of dignity" and "weakness." The patients' situation met the official requirements for accepted practice best in requests that were granted and least in refused requests. Refusal of requests were associated with a lesser degree of competence, and less unbearable and hopeless suffering.

"The complexity of EAS decision making is reflected in the fact that besides granting and refusing a request, three other situations could be distinguished," the authors conclude. "The decisions physicians make, the reasons they have for their decisions, and the way they arrive at their decisions seem to be based on patient evaluations. Physicians report compliance with the official requirements for accepted practice."

In an editorial accompanying the article, Susan M. Wolf, J.D., of the University of Minnesota Law School, writes, "The ultimate question remains-if you permit physicians to take life deliberately by assisting suicide or performing euthanasia, can you control the practice? Determining the answers will require detailed study in each health system and culture permitting assisted suicide or euthanasia. The Dutch have struggled mightily for more than two decades to devise a system to oversee physician-assisted suicide and euthanasia and keep both practices within agreed bounds. It is not clear that they have succeeded. Yet even if they were to succeed, that system might not work in the United States. The Dutch have universal health care coverage, long-standing relationships between physician and patient, and a far more homogenous society."

"Virtually all agree that it is irresponsible to permit assisted suicide and euthanasia without safeguards," Wolf concludes. "There must be limits and an effective way to police them. Yet it remains unclear that we know how to restrain these practices and assure physician reporting. The Dutch should be commended for wrestling with this problem. But even they may not have the answer to this immensely difficult question."
 

- August 8/22 issue of the Archives of Internal Medicine
 

Arch Intern Med. 2005;165:1698-1704

 
Subscribe to Euthanasia Newsletter
E-mail Address:

 

This study was funded by the Royal Dutch Medical Association (Utrecht) and the Dutch Ministry of Health, Welfare, and Sports (The Hague).

Related Euthanasia News

Indian scribe pleads for mercy killing
No incidences of physician-assisted suicide in the UK
Dutch study on end-of-life decisions (ELD) for children
Assessing physician compliance with the rules for euthanasia and assisted suicide
Why Patients are Motivated to Seek Death


For any corrections of factual information, to contact the editors or to send any medical news or health news press releases, use feedback form

Top of Page

 

© Copyright 2004 onwards by RxPG Medical Solutions Private Limited
Contact Us