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Cited by 117Palliative Care and End-of-Life IssuesPalliative and Oncologic CareEthics and bioethics in healthcare

Granted, undecided, withdrawn, and refused requests for euthanasia and physician-assisted suicide

Open access
Jansen-van der Weide, Marijke C., Onwuteaka-Philipsen, Bregje D., van der Wal, Gerrit·2005·Archives of Internal Medicine
DOI 10.1001/archinte.165.15.1698
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Abstract

BACKGROUND: The aims of this study were to obtain information about the characteristics of requests for euthanasia and physician-assisted suicide (EAS) and to distinguish among different types of situations that can arise between the request and the physician's decision. METHODS: All general practitioners in 18 of the 23 Dutch general practitioner districts received a written questionnaire in which they were asked to describe the most recent request for EAS they received. RESULTS: A total of 3614 general practitioners responded to the questionnaire (response rate, 60%). Of all explicit requests for EAS, 44% resulted in EAS. In the other cases the patient died before the performance (13%) or finalization of the decision making (13%), the patient withdrew the request (13%), or the physician refused the request (12%). Patients' most prominent symptoms were "feeling bad," "tiredness," and "lack of appetite." The most frequently mentioned 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 resulted in EAS and least in refused requests. A lesser degree of competence and less unbearable and hopeless suffering had the strongest associations with the refusal of a request. CONCLUSIONS: The complexity of EAS decision making is reflected in the fact that besides granting and refusing a request, 3 other situations could be distinguished. The decisions physicians make, the reasons they have for their decisions, and the way they arrived at their decisions seem to be based on patient evaluations. Physicians report compliance with the official requirements for accepted practice.

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  • Among 150 patients whose request was refused, 18% were depressed and 37% tired of living.

    “Finally, among the 150 patients whose request was refused, 18% were depressed and 37% tired of living.”

    From Euthanasia and assisted suicide in psychiatric patients: A systematic review of the literature (2021) · cites this paper as Jansen-van der Weide et al., 2005

    Table 1 (Characteristics of Patients Who Explicitly Request EAS) lists 150 patients whose requests were refused and reports that 37% gave ‘tired of living’ and 18% gave ‘depressed’ as reasons for requesting EAS. The claim turns the latter into a statement that 18% were depressed; the table separately reports depression as a symptom in 32% of this group. (LLM, conf=0.92)

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  • Among 144 patients who withdrew their EAS application, 10% initially requested EAS because of depression and 22% because they were tired of living.

    “Moreover, among the 144 patients who withdrew their EAS application, 10% initially requested EAS because of their depression and 22% because they were tired of living.”

    From Euthanasia and assisted suicide in psychiatric patients: A systematic review of the literature (2021) · cites this paper as Jansen-van der Weide et al., 2005

  • In a questionnaire to GPs about the most recent EAS requests (n=1,681), depression (7%) and being tired of living (17%) were among the reasons for requesting (p)EAS.

    “Analysis of the results of a questionnaire sent to GPs who were asked to describe the most recent EAS requests they had received (n=1,681 requests) (Jansen-van der Weide et al., 2005) showed that depression (7%) and to be tired of living (17%) were among the reasons for requesting (p)EAS.”

    From Euthanasia and assisted suicide in psychiatric patients: A systematic review of the literature (2021) · cites this paper as Jansen-van der Weide et al., 2005

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Research works printed but not linked: 1

  1. [12]12. van der Wal G, van der Heide A, Onwuteaka-Philipsen BD, van der Maas PJ. Medical Decision-making Concerning the End of Life: Practice and the Euthana- sia Review Procedure [in Dutch]. Utrecht, the Netherlands: Uitgeverij de Tijd- stroom; 2003.

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Authors
Jansen-van der Weide, M. C., Onwuteaka-Philipsen, B. D., & van der Wal, G.
Affiliations
Amsterdam UMC Location Vrije Universiteit Amsterdam (NL)
ORCID
Onwuteaka-Philipsen, Bregje D.
Venue
Archives of Internal Medicine
Publisher
American Medical Association (AMA)
Published
2005-08-08
Volume
165
Issue
15
Pages
1698
ISSN
0003-9926 (ISSN-L)
DOI
10.1001/archinte.165.15.1698
OpenAlex
W2135410627
Cited by
117
References
27
Citations by year
2025: 2 · 2024: 4 · 2023: 3 · 2022: 3 · 2021: 3 · 2020: 2 · 2019: 6 · 2018: 5 · 2017: 4 · 2016: 5 · 2015: 6 · 2014: 13 · 2013: 10 · 2012: 8
FWCI
6.61
Type
journal article
Language
en
Open access
Locations
  • Archives of Internal Medicine (publishedVersion)
  • PubMed (publishedVersion)
  • DigitalGeorgetown (Georgetown University Library) (submittedVersion)
  • Data Archiving and Networked Services (DANS) (submittedVersion)
Funders
Vrije Universiteit Amsterdam
Topics
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Palliative Care and End-of-Life Issues
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Palliative and Oncologic Care
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Ethics and bioethics in healthcare
Keywords
euthanasia, physician-assisted suicide, euthanasia requests, general practitioners, physician decision-making, patient suffering, patient competence, medical ethics, Dutch euthanasia law
MeSH terms
Adult, Aged, Aged, 80 and over, Decision Making, Euthanasia, Family Practice, Female, Humans, Male, Middle Aged, Netherlands, Suicide, Assisted, Guidelines as Topic, Guideline Adherence

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