TY - JOUR
T1 - Opinions about euthanasia and advanced dementia
T2 - a qualitative study among Dutch physicians and members of the general public
AU - Kouwenhoven, Pauline S C
AU - Raijmakers, Natasja J H
AU - van Delden, Johannes J M
AU - Rietjens, Judith A C
AU - van Tol, Donald G
AU - van de Vathorst, Suzanne
AU - de Graeff, Nienke
AU - Weyers, Heleen A M
AU - van der Heide, Agnes
AU - van Thiel, Ghislaine J M W
PY - 2015
Y1 - 2015
N2 - 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.
AB - 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.
KW - Dementia
KW - End-of-life decisions
KW - Ethics
KW - Euthanasia
KW - Law
KW - Public opinion
U2 - 10.1186/1472-6939-16-7
DO - 10.1186/1472-6939-16-7
M3 - Article
C2 - 25630339
SN - 1472-6939
VL - 16
JO - BMC Medical Ethics [E]
JF - BMC Medical Ethics [E]
M1 - 16:7
ER -