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Advance directives for euthanasia in dementia: do law-based opportunities lead to more euthanasia?
de Boer ME, Dröes RM, Jonker C, Eefsting JA, Hertogh CM.. Health policy (Amsterdam, Netherlands), 2010-07-27
Topic: Risk, prevention and care in population studies
Objective To obtain insight into current practices regarding compliance with advance directives for euthanasia (ADEs) in cases of incompetent patients with dementia in Dutch nursing homes, in light of the legal possibility offered by the new euthanasia law to perform euthanasia in these cases. Methods A written questionnaire was completed by 434 elderly care physicians (ECPs). Findings Over the years 2005-2006, many ECPs took care of patients with dementia and an ADE, actual life termination of these patients took place very rarely and never in incompetent patients. ECPs reported practical difficulties in determining the 'unbearableness' of the suffering and choosing the right moment of carrying out the ADE. Conclusions Although the enactment of the Dutch euthanasia law in theory provided a window of opportunity for euthanasia in incompetent patients with dementia and an ADE, it has not led to obvious changes in compliance with ADEs of this patient group in practice. Crucial in the reticent attitudes of ECPs appears to be the impossibility of patient-physician communication. This raises questions on the feasibility of the law on this point. In our opinion, the role of ADEs in end-of-life care of patients with advanced dementia in the Netherlands deserves serious reconsideration.
Key findings
- ECPs reported practical difficulties in determining the 'unbearableness' of the suffering and choosing the right moment of carrying out the ADE.
- Conclusions Although the enactment of the Dutch euthanasia law in theory provided a window of opportunity for euthanasia in incompetent patients with dementia and an ADE, it has not led to obvious changes in compliance with ADEs of this patient group in practice.
- Crucial in the reticent attitudes of ECPs appears to be the impossibility of patient-physician communication.
- This raises questions on the feasibility of the law on this point.
- In our opinion, the role of ADEs in end-of-life care of patients with advanced dementia in the Netherlands deserves serious reconsideration.
Study details
- Evidence strengthLow
How this study scored 36/100
Published in a peer-reviewed journal. Scored zero for study design, sample size, effect reported, studied in people and randomised / blinded because the record does not state it. We have no data on journal's citation record, times cited, citations per year, impact for its field and year, cited by studies here, still being cited, senior author's track record, institution's track record and multi-centre collaboration, so those were left out: it earned 21 of the 58 points we could judge it on, which is 36 out of 100.
| Component | Points | Why |
|---|---|---|
| Journal tier | 7 / 10 | Tier 3 — peer-reviewed journal (Health policy (Amsterdam, Netherlands)) |
| Journal's citation record | — / 4 | No journal record from OpenAlex — left out of this score |
| Study design | 0 / 12 | No study design recorded — scores zero, not guessed (not stated in the record — scored 0) |
| Strength of evidence | 1 / 5 | Rated “low” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 1 / 5 | 2010 — within 20 year(s) of the newest study here |
| Sample size | 0 / 4 | Participant count not stated — scores zero (not stated in the record — scored 0) |
| Effect reported | 0 / 3 | No effect size reported — scores zero (not stated in the record — scored 0) |
| Studied in people | 0 / 3 | Not stated whether this was studied in people — scores zero (not stated in the record — scored 0) |
| Randomised / blinded | 0 / 2 | No randomisation or blinding stated — scores zero (not stated in the record — scored 0) |
| Times cited | — / 7 | No citation count (not found in OpenAlex) — left out of this score |
| Citations per year | — / 5 | No citation count or no year — left out of this score |
| Impact for its field and year | — / 6 | No field-weighted citation impact (OpenAlex has none yet) — left out of this score |
| Cited by studies here | — / 6 | Not yet checked against this library's citation graph — left out of this score |
| Still being cited | — / 4 | No yearly citation counts — left out of this score |
| Senior author's track record | — / 4 | Senior author's record not available — left out of this score |
| Institution's track record | — / 3 | No institution listed in OpenAlex — left out of this score |
| Multi-centre collaboration | — / 3 | Institutions not listed — left out of this score |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 20667617) |
| Free to read | 0 / 2 | Behind a paywall — scores zero |
| Points | 21 / 58 | Scored on 11 of 20 parts. We have no data for the rest, so they are left out: 21 of the 58 points we could judge it on is 36 out of 100. |
| Total | 36 / 100 | — |
What each of these 20 components measures, and what this score is not →
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APA 7th
de Boer, M. E., Dröes, R. M., Jonker, C., Eefsting, J. A., & Hertogh, C. M. (2010). Advance directives for euthanasia in dementia: do law-based opportunities lead to more euthanasia? Health policy (Amsterdam, Netherlands). https://doi.org/10.1016/j.healthpol.2010.06.024
Vancouver
de Boer ME, Dröes RM, Jonker C, Eefsting JA, Hertogh CM. Advance directives for euthanasia in dementia: do law-based opportunities lead to more euthanasia? Health policy (Amsterdam, Netherlands). 2010. doi:10.1016/j.healthpol.2010.06.024. PMID: 20667617.
BibTeX
@article{deboer2010-20667617,
author = {de Boer, M. E. and Dröes, R. M. and Jonker, C. and Eefsting, J. A. and Hertogh, C. M.},
title = {{Advance directives for euthanasia in dementia: do law-based opportunities lead to more euthanasia?}},
journal = {Health policy (Amsterdam, Netherlands)},
year = {2010},
doi = {10.1016/j.healthpol.2010.06.024},
pmid = {20667617},
url = {https://doi.org/10.1016/j.healthpol.2010.06.024}
}