Advance directives for euthanasia in dementia: do law-based opportunities lead to more euthanasia?
Abstract
Objective To obtain insight into current practices regarding compliance with advance directives for euthanasia (ADEs) in cases of incompetent patients with dementia in Dutch nursing homes, in light of the legal possibility offered by the new euthanasia law to perform euthanasia in these cases.Methods A written questionnaire was completed by 434 elderly care physicians (ECPs).Findings Over the years 2005-2006, many ECPs took care of patients with dementia and an ADE, actual life termination of these patients took place very rarely and never in incompetent patients. ECPs reported practical difficulties in determining the 'unbearableness' of the suffering and choosing the right moment of carrying out the ADE.Conclusions Although the enactment of the Dutch euthanasia law in theory provided a window of opportunity for euthanasia in incompetent patients with dementia and an ADE, it has not led to obvious changes in compliance with ADEs of this patient group in practice. Crucial in the reticent attitudes of ECPs appears to be the impossibility of patient-physician communication. This raises questions on the feasibility of the law on this point. In our opinion, the role of ADEs in end-of-life care of patients with advanced dementia in the Netherlands deserves serious reconsideration.
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Dutch physicians find it difficult to determine whether an incompetent person experiences her dementia as unbearable and hopeless suffering.
“studies that report Dutch physicians find it difficult to determine whether an incompetent person experiences her dementia as unbearable and hopeless suffering.(24, 27)”
From Euthanasia and Assisted Suicide of Persons With Dementia in the Netherlands (2020) · cites this paper as [24]
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- Authors
- de Boer, M. E., Dröes, R.-M., Jonker, C., Eefsting, J. A., & Hertogh, C. M. P. M.
- Affiliations
- Amsterdam Public Health (NL)
- Amsterdam UMC Location Vrije Universiteit Amsterdam (NL)
- Venue
- Health Policy
- Publisher
- Elsevier BV
- Published
- 2010-12
- Volume
- 98
- Issue
- 2-3
- Pages
- 256-262
- ISSN
- 0168-8510 (ISSN-L)
- OpenAlex
- W2138364957
- Cited by
- 78
- References
- 14
- Citations by year
- 2026: 1 · 2025: 1 · 2024: 4 · 2023: 3 · 2022: 5 · 2021: 7 · 2020: 4 · 2019: 2 · 2018: 33 · 2017: 1 · 2015: 6 · 2014: 3 · 2013: 3 · 2012: 4
- FWCI
- 2.53
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Health Policy (publishedVersion)
- PubMed (publishedVersion)
- Pure Amsterdam UMC (publishedVersion)
- Amsterdam UMC (VU Amsterdam) - Institutional Repository (publishedVersion)
- VU Research Portal (publishedVersion)
- RePEc: Research Papers in Economics (submittedVersion)
- Digital Academic REpository of VU University Amsterdam (Vrije Universiteit Amsterdam) (submittedVersion)
- 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 › Ethics and bioethics in healthcare
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Palliative and Oncologic Care
- Keywords
- euthanasia, dementia, incompetent patients, nursing homes, Dutch euthanasia law, end-of-life care, patient-physician communication, legal compliance, unbearable suffering
- MeSH terms
- Adult, Dementia, Euthanasia, Female, Health Policy, Humans, Male, Middle Aged, Netherlands, Nursing Homes, Surveys and Questionnaires, Advance Directives
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