Factors associated with requesting and receiving euthanasia: a nationwide mortality follow-back study with a focus on patients with psychiatric disorders, dementia, or an accumulation of health problems related to old age

• Published in: BMC medicine 2019-02, Vol.17 (1), p.39-12, Article 39
• Main Authors: Evenblij, Kirsten, Pasman, H Roeline W, van der Heide, Agnes, Hoekstra, Trynke, Onwuteaka-Philipsen, Bregje D
• Format: Article
• Language: English
• Subjects: Accumulation; Adolescent; Adult; Aged; Aged, 80 and over; Aging; Analysis; Assisted suicide; Cancer; Cross-Sectional Studies; Death; Dementia; Dementia - psychology; Dementia disorders; Disorders; End-of-life care; Epidemiology; Euthanasia; Euthanasia - trends; Female; General practitioners; Health; Health aspects; Health problems; Humans; Legislation; Male; Medical personnel; Medical research; Mental disorders; Mental Disorders - psychology; Mental health; Middle Aged; Minority & ethnic groups; Mortality; Nervous system diseases; Neurological diseases; Pain; Palliative care; Patients; Physicians; Psychiatrists; Right to die; Suicide; Suicides & suicide attempts; Terminal care; Young Adult
• ISSN: 1741-7015; 1741-7015
• DOI: 10.1186/s12916-019-1276-y

Recently, euthanasia and assisted suicide (EAS) in patients with psychiatric disorders, dementia, or an accumulation of health problems has taken a prominent place in the public debate. However, limited is known about this practice. The purpose of this study was threefold: to estimate the frequency of requesting and receiving EAS among people with (also) a psychiatric disorder, dementia, or an accumulation of health problems; to explore reasons for physicians to grant or refuse a request; and to describe differences in characteristics, including the presence of psychiatric disorders, dementia, and accumulation of health problems, between patients who did and did not request EAS and between patients whose request was or was not granted. A nationwide cross-sectional survey study was performed. A stratified sample of death certificates of patients who died between 1 August and 1 December 2015 was drawn from the central death registry of Statistics Netherlands. Questionnaires were sent to the certifying physician (n = 9351, response 78%). Only deceased patients aged ≥ 17 years and who died a non-sudden death were included in the analyses (n = 5361). The frequency of euthanasia requests among deceased people who died non-suddenly and with (also) a psychiatric disorder (11.4%), dementia (2.1%), or an accumulation of health problems (8.0%) varied. Factors positively associated with requesting euthanasia were age (