Opinions of health care professionals and the public after eight years of euthanasia legislation in the Netherlands: A mixed methods approach
Open accessAbstract
BACKGROUND: The practice of euthanasia and physician-assisted suicide (PAS) in the Netherlands has been regulated since 2002 by the Euthanasia Act. In the ongoing debate about the interpretation of this Act, comparative information about the opinions of the different stakeholders is needed. AIM: To evaluate the opinions of Dutch physicians, nurses and the general public on the legal requirements for euthanasia and PAS. DESIGN: A cross-sectional survey among Dutch physicians and nurses in primary and secondary care and members of the Dutch general public, followed by qualitative interviews among selected respondents. The participants were: 793 physicians, 1243 nurses and 1960 members of the general public who completed the questionnaire; 83 were interviewed. RESULTS: Most respondents agreed with the requirement of a patient request (64-88%) and the absence of a requirement concerning life expectancy (48-71%). PAS was thought acceptable by 24-39% of respondents for patients requesting it because of mental suffering due to loss of control, chronic depression or early dementia. In the case of severe dementia, one third of physicians, 58% of nurses and 77% of the general public agreed with performing euthanasia based on an advance directive. Interviewees illustrated these findings and supported the Act. CONCLUSIONS: Health care professionals and the general public mostly support the legal requirements for euthanasia and PAS. The law permits euthanasia or PAS for mental suffering but this possibility is not widely endorsed. The general public is more liberal towards euthanasia for advanced dementia than health care professionals. We conclude that there is ample support for the law after eight years of legal euthanasia.
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Only a minority of physicians are willing to perform euthanasia for psychological suffering, although the number is increasing over time.
“only a minority of physicians are willing to perform euthanasia for psychological suffering (although the number is increasing over time)”
From Psychiatric patients requesting euthanasia: Guidelines for sound clinical and ethical decision making (2019) · cites this paper as Kouwenhoven et al., 2013
Evidence from the Netherlands shows that requests for euthanasia from psychiatric patients (as well as from patients suffering from severe dementia and patients being tired of living) are much less likely to be granted as compared to requests for euthanasia from patients suffering from physical disorders.
“evidence from the Netherlands shows that requests for euthanasia from psychiatric patients (as well as from patients suffering from severe dementia and patients being tired of living) are much less likely to be granted as compared to requests for euthanasia from patients suffering from physical disorders”
From Psychiatric patients requesting euthanasia: Guidelines for sound clinical and ethical decision making (2019) · cites this paper as Kouwenhoven et al., 2013
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- Authors
- Kouwenhoven, P. S., Raijmakers, N. J., van Delden, J. J., Rietjens, J. A., Schermer, M. H., van Thiel, G. J., Trappenburg, M. J., van de Vathorst, S., van der Vegt, B. J., Vezzoni, C., Weyers, H., van Tol, D. G., & van der Heide, A.
- Affiliations
- University Medical Center Utrecht (NL)
- Erasmus MC (NL)
- Julius Center, University Medical Center Utrecht, The Netherlands
- Utrecht University (NL)
- Department of Ethics and Philosophy of Medicine, Erasmus MC, The Netherlands
- Department of Health Sciences, University of Groningen, The Netherlands
- University of Groningen (NL)
- Department of Public Health, Erasmus MC, The Netherlands
- ORCID
- Venue
- Palliative Medicine
- Publisher
- SAGE Publications
- Published
- 2012-06-13
- Volume
- 27
- Issue
- 3
- Pages
- 273-280
- ISSN
- 0269-2163 (ISSN-L)
- 1477-030X
- OpenAlex
- W1998057600
- Cited by
- 151
- References
- 20
- Citations by year
- 2026: 7 · 2025: 7 · 2024: 5 · 2023: 7 · 2022: 7 · 2021: 9 · 2020: 18 · 2019: 13 · 2018: 39 · 2017: 5 · 2016: 10 · 2015: 12 · 2014: 5 · 2013: 6 · 2012: 1
- FWCI
- 7.41
- Type
- journal article
- Language
- en
- Open access
- green
- www.nivel.nl
- Locations
- Palliative Medicine (publishedVersion)
- PubMed (publishedVersion)
- EUR Research Repository (Erasmus University Rotterdam) (publishedVersion)
- University of Groningen research database (University of Groningen / Centre for Information Technology) (publishedVersion)
- Data Archiving and Networked Services (DANS) (submittedVersion)
- EUR Research Repository (Erasmus University Rotterdam) (submittedVersion)
- Data Archiving and Networked Services (DANS) (submittedVersion, other-oa)
- Iris (University of Trento) (submittedVersion)
- Pure Amsterdam UMC (submittedVersion)
- University of Groningen research database (University of Groningen / Centre for Information Technology) (submittedVersion)
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Palliative and Oncologic Care
- 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
- Keywords
- euthanasia, physician-assisted suicide, euthanasia legislation, public opinion, physician attitudes, nurse attitudes, advance directives, advanced dementia, psychological suffering, patient requests
- MeSH terms
- Attitude of Health Personnel, Cross-Sectional Studies, Euthanasia, Female, Humans, Male, Middle Aged, Netherlands, Public Opinion, Surveys and Questionnaires, Qualitative Research
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