Dutch euthanasia rates steady10th May 2007
A study into the use of euthanasia in the Netherlands in the past 10 years has found no increase in the practice since it was legalised in 2002.
The study in the New England Journal of Medicine found that, in 2005, 1.7% of all deaths in the Netherlands were the result of euthanasia and 0.1% were the result of physician-assisted suicide. This was a substantial fall compared with a euthanasia rate of 2.6% and an assisted suicide rate of 0.2% in 2001.
The study sent questionnaires to doctors who had attended 6,860 deaths over the last 10 years. More than three-quarters (77.8%) of physicians responded. While demographic factors and anomalies in doctor assessment of the effects of opioids on terminally ill patients might account in part for the decline, experts said there was still no evidence of a 'slippery slope' of more and more assisted deaths as a result of the legislation.
Timothy Quill, director of the Center for Ethics, Humanities and Palliative Care at the University of Rochester Medical Center in Rochester, New York, said it showed it was important to have an open conversation about euthanasia in the United States, where Oregon is the only state to have taken up the practice, in spite of growing calls for it by the palliative care lobby.
Dr. Nancy W. Dickey, president of the Texas A&M Health Science Center and vice chancellor for health affairs for the Texas A&M System, said physicians had become better equipped to offer a wide variety of palliative care, meaning they only very rarely had to resort to assisted death.
In the Netherlands, euthanasia is defined as death resulting from medication administered by a physician with the intention of hastening death at the request of the patient. In assisted suicide, the patient hastens death by giving him or herself medication prescribed by a physician.
Although neither procedure was legal in the Netherlands in the early 1990s, physicians were generally not prosecuted if they had adhered to certain requirements.
Reporting rates in the Netherlands for euthanasia and physician-assisted suicide were just 18%. That rate rose to 41% after an official reporting procedure was introduced in 1993, and again to around 80% following legalisation.
Study co-author Bregje Onwuteaka-Philipsen, associate professor at the VU University Medical Center in Amsterdam, EMGO Institute/Department of Public and Occupational Health, said that the increase in the reporting of euthanasia and physician-assisted suicide showed that that goal of the euthanasia law had been met.
She said approximately 8,400 people per year explicitly requested euthanasia or physician-assisted suicide in the Netherlands, at which point physicians must determine whether or not to grant the request according to legal criteria. This process results in approximately 2,300 cases of euthanasia and 100 cases of physician-assisted suicide per year which, together, make up 1.8% of all deaths in the Netherlands, she said.
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