Why are people euthanized

Page options Print this page. What is Euthanasia? The term is derived from the Greek word euthanatos which means easy death. The ethics of euthanasia Euthanasia raises a number of agonising moral dilemmas: is it ever right to end the life of a terminally ill patient who is undergoing severe pain and suffering? There are also a number of arguments based on practical issues.

Killing or letting die Euthanasia can be carried out either by taking actions , including giving a lethal injection, or by not doing what is necessary to keep a person alive such as failing to keep their feeding tube going.

Euthanasia and pain relief It's not euthanasia to give a drug in order to reduce pain, even though the drug causes the patient to die sooner. Mercy killing Very often people call euthanasia 'mercy killing', perhaps thinking of it for someone who is terminally ill and suffering prolonged, unbearable pain. Why people want euthanasia Most people think unbearable pain is the main reason people seek euthanasia, but some surveys in the USA and the Netherlands showed that less than a third of requests for euthanasia were because of severe pain.

See also. No description of these groups was provided to the physicians to classify patients; thus, physicians will most likely have interpreted these categories in the context of the Dutch euthanasia act and the current debate.

The cause of death and specialty of the certifying physician were derived from the death certificate. This weighting procedure was similar to previous mortality follow-back studies [ 3 , 4 , 18 , 19 , 20 , 21 ]. Due to this procedure, the percentages that are reported cannot be derived from the absolute unweighted numbers. Two multivariable logistic regression models were developed: one to identify factors associated with patients requesting EAS and one to identify factors associated with receiving EAS.

The latter model was developed on a subset of the sample: patients who made an EAS request. First, the univariable association between each independent variable and the dependent variables requesting EAS and receiving EAS was analyzed. Sensitivity analyses showed this was mainly driven by i collinearity between two variables, dementia and attending physicians; ii strong associations between cause of death, requesting EAS, and dementia and between cause of death, requesting EAS, and attending physician; and iii empty cells demonstrating the likelihood of unstable models.

Therefore, we also performed the multivariable analyses for both requesting EAS and receiving EAS without dementia and attending physician. The results of the multivariable regression analyses including all independent variables including dementia and attending physician are reported as main outcomes. The characteristics of the study sample are provided in Table 1. Figure 1 shows that Of the people with a psychiatric disorder, The prevalence of EAS requests was lower among people with an accumulation of health problems 8.

Six percent of all deceased patients had received euthanasia; this percentage was lower among people who had a psychiatric disorder 4. Frequency of deceased patients who did or did not receive euthanasia. Dutch and Western immigrants were 8. Compared with people who died of cancer, people who died of cardiovascular disorders were less likely to request EAS while people who died of pulmonary disorders, neurological disorders, or another cause were more likely.

People with an accumulation of health problems OR 0. People whose attending physician was a medical specialist or an elderly care specialist had lower odds of requesting EAS OR 0. People who were supported by pain specialists OR 2. However, people who died of cancer were now more likely to request EAS compared to people who died of any other cause.

An accumulation of health problems dropped from the model. Table 3 shows that across the full sample, the two most important reasons for the attending physician to grant the request were the lack of prospect of improvement In case of a psychiatric disorder, the presence of severe symptoms other than pain In case of dementia, the loss of dignity Finally, in case of an accumulation of health problems, the presence of symptoms other than pain Among those with a psychiatric disorder, dementia, or an accumulation of health problems, the most important reason to refuse the request was that the due care criteria were not met, especially regarding the well-considered nature of the request.

Among all deceased patients, the most important reason was that the patient died before the request was granted. Table 4 shows associations between receiving EAS and patient and care characteristics. In multivariable analysis, most associations remained significant. People who died of neurological disorders or another cause had 4. People with a psychiatric disorder and an accumulation of health problems had lower odds of receiving EAS compared with people without these conditions OR 0.

People whose attending physician was a medical specialist or an elderly care specialist were less likely to receive EAS OR 0. Those who were supported by a palliative care consultant in the last month of life were also less likely to receive EAS OR 0. The frequency of EAS requests among deceased people who died non-suddenly and who had psychiatric disorders Less than half of these requests led to EAS. Cause of death neurological disorders or another cause and attending physician general practitioner were also positively associated with receiving euthanasia.

Psychiatric disorders, dementia, and accumulation of health problems were negatively associated with requesting and receiving EAS. EAS in people with psychiatric disorders, dementia, and an accumulation of health problems is a highly debated subject, but this practice rarely occurs. Partially, this can be explained by reluctance of physicians to perform EAS in these patients [ 23 ]. Moreover, having a psychiatric disorder or an accumulation of health problems was statistically significantly associated with a lower likelihood of having a request being carried out.

The main reasons to refuse a request are doubts about whether the request was well-considered and about the unbearableness of the suffering. These findings corroborate previous studies [ 26 , 27 ]. This study is the first to show that people with dementia or an accumulation of health problems are less likely to request EAS compared to people without these conditions which may explain part of the lower frequency of EAS in people with these conditions.

Possibly, the lower frequency of requests among people with dementia and an accumulation of health problems can be explained by the slow and gradual decline characterizing both dementia and an accumulation of health problems leading to the gradual acceptance of a declining health condition [ 28 , 29 , 30 ].

In addition, in case of advanced dementia, patients lose the ability to make a well-considered request for EAS. The question of how policy makers and care providers should respond to these requests is, therefore, highly relevant. This study showed that younger people are more likely to request EAS which is consistent with previous studies in the Netherlands and Belgium [ 5 , 6 , 33 ]. Younger people tend to have more permissive and liberal attitudes compared to older people and are more likely to support EAS [ 34 , 35 ].

Also, a strong positive association between ethnicity and requesting EAS was found, with Dutch or Western migrants being 8. Cultural and religious values and beliefs have frequently been reported to profoundly influence the perceptions of death and end-of-life decision-making [ 36 , 37 , 38 , 39 , 40 ]. People who died due to a neurological disorder were almost four times more likely to receive EAS compared to people with cancer which corresponds with previous findings [ 5 , 33 , 41 ].

ALS disease, which is known for its progressive, severe physical symptoms and lack of effective treatments, probably contributes the most to this finding. This confirms previous research in Belgium and the Netherlands [ 5 , 42 ]. Finally, prior to granting a request, a physician must be certain that there is no other reasonable solution; optimizing end-of-life care is one of them.

Such committees comprise, at the minimum, a medical doctor, an ethicist and a legal expert. The committee assesses whether the physician who performed the euthanasia has fulfilled the statutory due care criteria. The review committee procedure is intended to ensure greater transparency and consistency in the way cases are reported and assessed. The procedure benefits both the Public Prosecution Service and physicians.

The statutory criteria and the findings of the review committees tell doctors how their actions in particular cases are likely to stand up to legal, medical and ethical scrutiny. A DNR do not resuscitate medallion indicates that the wearer does not want to be resuscitated in a medical emergency.

DNR medallions issued by NVVE a Dutch organisation that provides information and advice about euthanasia and assisted suicide before 7 June are still valid. You are here: Home Topics Euthanasia Euthanasia, assisted suicide and non-resuscitation on request Search within English part of Government. Euthanasia, assisted suicide and non-resuscitation on request Euthanasia is performed by the attending physician administering a fatal dose of a suitable drug to the patient on his or her express request.

Among weekly churchgoers, Gallup found that 55 percent were in favor of a doctor ending the life of a patient who is terminally ill, compared with 87 percent of those who do not regularly attend church. It is also a political issue. In countries where euthanasia or assisted suicide are legal, they are responsible for a total of between 0.

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