Around one in three Dutch doctors would be prepared to help someone with early dementia, mental illness, or who is ‘tired of living’ to die, reveals a small survey published online in the Journal of Medical Ethics.
In the Netherlands, euthanasia or assisted suicide for those whose suffering is psychiatric/psychological in nature is legally permissible, but it represents a fraction of the numbers of patients who are helped to die in this way.
And while there is no ‘right’ to euthanasia, the freedom of a doctor to refuse the request on personal grounds has been widely debated, following some well-publicised cases.
In a bid to find out what Dutch doctors think of euthanasia and assisted suicide, the researchers canvassed the views of 2500 randomly targeted general practitioners (family doctors) and specialists in the fields of elderly care, cardiology, respiratory medicine, intensive care, neurology and internal medicine between October 2011 and June 2012.
The doctors were asked whether they had ever helped a patient with cancer, other physical disease, mental illness, early or advanced dementia, or someone without any severe physical ailments, but who was tired of living, to die. Those who had not done so were asked if they would even consider helping someone to die, and under what circumstances.
Four out of 10 would be prepared to help someone with early stage dementia to die, but only one in three would do this for someone with late stage dementia, even if that person had written an advance directive for euthanasia.
Around one in four (27%) would be prepared to help someone tired of living to die if they had a severe medical condition. But fewer than one in five (18%) would do so in these circumstances if the person had no other medical grounds for suffering.
In a linked blog, lead author Dr Eva Bolt of the EMGO Institute for Health and Care Research,
Amsterdam, The Netherlands, commented: “Each physician needs to form his or her own standpoint on euthanasia, based on legal boundaries and personal values.”
Dr. James A. Colbert of Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts, said the survey results are "not that surprising."
Dr. Colbert suggested we focus our attention more on palliative care.
"A much more important issue to focus our attention on is: how do we make sure that all patients are comfortable and well cared for at the end of life? Palliative care is such an essential component of medical care, yet very few patients will see a palliative care practitioner. Studies have shown that patients with cancer who see a palliative care practitioner have better quality of life and in some cases even live longer than other cancer patients who are only treated by oncologists”.