Can physicians conceive of performing euthanasia in case of psychiatric disease, dementia or being tired of living?

Topic: Risk, prevention and care in population studies

Background Euthanasia and physician-assisted suicide (EAS) in patients with psychiatric disease, dementia or patients who are tired of living (without severe morbidity) is highly controversial. Although such cases can fall under the Dutch Euthanasia Act, Dutch physicians seem reluctant to perform EAS, and it is not clear whether or not physicians reject the possibility of EAS in these cases. Aim To determine whether physicians can conceive of granting requests for EAS in patients with cancer, another physical disease, psychiatric disease, dementia or patients who are tired of living, and to evaluate whether physician characteristics are associated with conceivability. A cross-sectional study (survey) was conducted among 2269 Dutch general practitioners, elderly care physicians and clinical specialists. Results The response rate was 64% (n=1456). Most physicians found it conceivable that they would grant a request for EAS in a patient with cancer or another physical disease (85% and 82%). Less than half of the physicians found this conceivable in patients with psychiatric disease (34%), early-stage dementia (40%), advanced dementia (29-33%) or tired of living (27%). General practitioners were most likely to find it conceivable that they would perform EAS. Conclusions This study shows that a minority of Dutch physicians find it conceivable that they would grant a request for EAS from a patient with psychiatric disease, dementia or a patient who is tired of living. For physicians who find EAS inconceivable in these cases, legal arguments and personal moral objections both probably play a role.

Key findings

• Aim To determine whether physicians can conceive of granting requests for EAS in patients with cancer, another physical disease, psychiatric disease, dementia or patients who are tired of living, and to evaluate whether physician characteristics are associated with conceivability.
• Results The response rate was 64% (n=1456).

Why it matters

In this survey of Dutch physicians, only a minority said they could conceive of granting a request for euthanasia or physician-assisted suicide in patients with psychiatric disease, early-stage dementia, advanced dementia or who were tired of living. It describes physicians' views and does not test any treatment, cure or prevention for Alzheimer's disease.

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Study details

• Study designcross-sectional
• Participants1,456
• Evidence strengthLow

Read the original

• DOI: 10.1136/medethics-2014-102150
• PubMed: 25693947
• Original source →
• Free full text: Pure Amsterdam UMC →

Full text: free to read — OpenAlex lists this copy as free to read: the link above (checked 6 Feb 1020).

@article{bolt2015-25693947,
  author  = {Bolt, E. E. and Snijdewind, M. C. and Willems, D. L. and van der Heide, A. and Onwuteaka-Philipsen, B. D.},
  title   = {{Can physicians conceive of performing euthanasia in case of psychiatric disease, dementia or being tired of living?}},
  journal = {Journal of medical ethics},
  year    = {2015},
  doi     = {10.1136/medethics-2014-102150},
  pmid    = {25693947},
  url     = {https://doi.org/10.1136/medethics-2014-102150}
}

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