Involvement of palliative care in euthanasia practice in a context of legalized euthanasia: a population-based mortality follow-back study
Open accessAbstract
BACKGROUND: In the international debate about assisted dying, it is commonly stated that euthanasia is incompatible with palliative care. In Belgium, where euthanasia was legalized in 2002, the Federation for Palliative Care Flanders has endorsed the viewpoint that euthanasia can be embedded in palliative care. AIM: To examine the involvement of palliative care services in euthanasia practice in a context of legalized euthanasia. DESIGN: Population-based mortality follow-back survey. SETTING/PARTICIPANTS: Physicians attending a random sample of 6871 deaths in Flanders, Belgium, in 2013. RESULTS: People requesting euthanasia were more likely to have received palliative care (70.9%) than other people dying non-suddenly (45.2%) (odds ratio = 2.1 (95% confidence interval, 1.5-2.9)). The most frequently indicated reasons for non-referral to a palliative care service in those requesting euthanasia were that existing care already sufficiently addressed the patient's palliative and supportive care needs (56.5%) and that the patient did not want to be referred (26.1%). The likelihood of a request being granted did not differ between cases with or without palliative care involvement. Palliative care professionals were involved in the decision-making process and/or performance of euthanasia in 59.8% of all euthanasia deaths; this involvement was higher in hospitals (76.0%) than at home (47.0%) or in nursing homes (49.5%). CONCLUSION: In Flanders, in a context of legalized euthanasia, euthanasia and palliative care do not seem to be contradictory practices. A substantial proportion of people who make a euthanasia request are seen by palliative care services, and for a majority of these, the request is granted.
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Belgium deliberately and dramatically increased funding for palliative care when it legalised assisted dying, legislating that palliative care is a patient right in 2002.
“Belgium deliberately and dramatically increased funding for palliative care when it legalised assisted dying, legislating that palliative care is a patient right in 2002.23”
From Social determinants of health and slippery slopes in assisted dying debates: lessons from Canada (2021) · cites this paper as [23]
The Introduction states that Belgium legalized euthanasia in 2002 and passed a palliative-care law that same year, making palliative care a basic patient right and providing measures to improve access. It does not say that funding increased, much less that the increase was deliberate or dramatic (searched for funding, investment, and budget). (LLM, conf=0.89)
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References 26 · Cited by 77
Research works printed but not linked: 2
- [12]Wet betreffende Palliatieve Zorg [Act on palliative care]. Belgian Law Gaz 2002; 26: 28515– 28520.
- [29]Desmet M. Palliative care and euthanasia: enemies, friends or neighbours? Streven 2013; 80(11): 965– 979 (in Dutch).
- Authors
- Dierickx, S., Deliens, L., Cohen, J., & Chambaere, K.
- Affiliations
- Vrije Universiteit Brussel (BE)
- End-of-life Care Research Group, Vrije Universiteit Brussel (VUB) and Ghent University, Brussels, Belgium
- Corresponding author
- Dierickx, Sigrid
- Venue
- Palliative Medicine
- Publisher
- SAGE Publications
- Published
- 2017-08-29
- Volume
- 32
- Issue
- 1
- Pages
- 114-122
- ISSN
- 0269-2163 (ISSN-L)
- 1477-030X
- PMC
- PMC5758933
- OpenAlex
- W2752375431
- Cited by
- 77
- References
- 26
- Citations by year
- 2026: 2 · 2025: 5 · 2024: 8 · 2023: 7 · 2022: 13 · 2021: 9 · 2020: 19 · 2019: 7 · 2018: 7
- FWCI
- 8.46
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Locations
- Palliative Medicine (publishedVersion, cc-by-nc)
- Europe PMC (PubMed Central) (publishedVersion, cc-by-nc)
- PubMed Central (publishedVersion, cc-by-nc)
- PubMed (publishedVersion)
- Ghent University Academic Bibliography (Ghent University) (publishedVersion, other-oa)
- Ghent University Academic Bibliography (Ghent University) (submittedVersion, other-oa)
- VUBIR (Vrije Universiteit Brussel) (submittedVersion)
- Funders
- Agentschap voor Innovatie door Wetenschap en Technologie (100036)
- 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, palliative care, assisted dying, legalization of euthanasia, palliative care referral, palliative care professionals, euthanasia decision-making, Flanders
- MeSH terms
- Adolescent, Adult, Aged, Aged, 80 and over, Belgium, Decision Making, Euthanasia, Female, Humans, Male, Middle Aged, Palliative Care, Surveys and Questionnaires, Terminal Care, Suicide, Assisted, Young Adult
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