Opinions about euthanasia and advanced dementia: a qualitative study among Dutch physicians and members of the general public
Open accessAbstract
BACKGROUND: The Dutch law states that a physician may perform euthanasia according to a written advance euthanasia directive (AED) when a patient is incompetent as long as all legal criteria of due care are met. This may also hold for patients with advanced dementia. We investigated the differing opinions of physicians and members of the general public on the acceptability of euthanasia in patients with advanced dementia. METHODS: In this qualitative study, 16 medical specialists, 19 general practitioners, 16 elderly physicians and 16 members of the general public were interviewed and asked for their opinions about a vignette on euthanasia based on an AED in a patient with advanced dementia. RESULTS: Members of the general public perceived advanced dementia as a debilitating and degrading disease. Physicians emphasized the need for direct communication with the patient when making decisions about euthanasia. Respondent from both groups acknowledged difficulties in the assessment of patients' autonomous wishes and the unbearableness of their suffering. CONCLUSION: Legally, an AED may replace direct communication with patients about their request for euthanasia. In practice, physicians are reluctant to forego adequate verbal communication with the patient because they wish to verify the voluntariness of patients' request and the unbearableness of suffering. For this reason, the applicability of AEDs in advanced dementia seems limited.
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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 [27]
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References 12 · Cited by 58
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- The pre-publication history for this paper can be accessed here: http://www.biomedcentral.com/1472-6939/16/7/prepub
- Authors
- Kouwenhoven, P. S., Raijmakers, N. J., van Delden, J. J., Rietjens, J. A., van Tol, D. G., van de Vathorst, S., de Graeff, N., Weyers, H. A., van der Heide, A., & van Thiel, G. J.
- Affiliations
- University Medical Center Utrecht (NL)
- Erasmus MC (NL)
- University of Groningen (NL)
- Venue
- BMC Medical Ethics
- Published
- 2015-01-28
- Volume
- 16
- Issue
- 1
- Pages
- 7-7
- ISSN
- 1472-6939 (ISSN-L)
- PMC
- PMC4350907
- OpenAlex
- W2124358402
- Cited by
- 58
- References
- 12
- Citations by year
- 2026: 3 · 2025: 4 · 2024: 4 · 2023: 5 · 2022: 7 · 2021: 7 · 2020: 7 · 2019: 11 · 2018: 3 · 2017: 4 · 2016: 3
- FWCI
- 3.57
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- BMC Medical Ethics (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- EUR Research Repository (Erasmus University Rotterdam) (publishedVersion, other-oa)
- University of Groningen research database (University of Groningen / Centre for Information Technology) (publishedVersion, cc-by)
- EUR Research Repository (Erasmus University Rotterdam) (submittedVersion, other-oa)
- RePub (Erasmus University Rotterdam) (submittedVersion, other-oa)
- Data Archiving and Networked Services (DANS) (submittedVersion, other-oa)
- Utrecht University Repository (Utrecht University) (submittedVersion, other-oa)
- RePub (Erasmus University Rotterdam) (submittedVersion)
- University of Groningen research database (University of Groningen / Centre for Information Technology) (submittedVersion, cc-by)
- 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, advanced dementia, physician attitudes, public attitudes, patient autonomy, patient communication, unbearable suffering, Dutch euthanasia law
- MeSH terms
- Adult, Attitude, Attitude of Health Personnel, Communication, Decision Making, Dementia, Ethics, Medical, Euthanasia, Female, Humans, Informed Consent, Male, Middle Aged, Netherlands, Physicians, Public Opinion, Surveys and Questionnaires, Stress, Psychological, Advance Directives, Mental Competency, Personal Autonomy, Qualitative Research, Young Adult
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