Dutch Euthanasia Rates Unchanged After Legalization

HealthDay – 1 hr 2 mins ago TUESDAY, July 10 (HealthDay News) -- The rates of euthanasia and assisted suicide in the Netherlands in 2010 were comparable to the rates before the practices became legal in 2002, a new study finds.

In euthanasia, a doctor administers lethal drugs to a patient who has requested that his or her life be ended. In assisted suicide, a patient self-administers lethal drugs provided by a doctor.

Researchers analyzed the Netherlands' death-registry data and found that the total number of euthanasia and assisted-suicide deaths in 2010 was 4,050, slightly less than 3 percent of all deaths.

The rates of euthanasia and assisted suicide in the Netherlands decreased between 2002 and 2005, but increased between 2005 and 2010. The increase was due largely to a rise in the number of patients requesting to end their lives, the researchers said.

The study was published online July 10 in the journal The Lancet.

Contrary to concerns expressed by critics, these findings show that "the frequency of physicians ending a patient's life in the absence of an explicit request does not seem to be increased in countries where euthanasia is legalized," lead author Bregje Onwuteaka-Philipsen, a professor at the VU University Medical Centre in Amsterdam, said in a journal news release. "In the Netherlands, it decreased significantly."

Euthanasia is legal in three countries: the Netherlands, Belgium and Luxembourg. Assisted suicide is legal in the aforementioned countries, as well as in Switzerland and the U.S. states of Montana, Oregon and Washington.

Dr. Bernard Lo, director of the program in medical ethics at the University of California, San Francisco, said in an accompanying editorial that the researchers should be commended "for their careful, rigorous study."

"But additional information from in-depth interviews in cases that raise ethical concerns is needed," said Lo, who also is president of the Greenwall Foundation, a bioethics research-funding foundation in New York City.

"How do physicians think through these difficult cases? What key ethical or clinical concepts are uncertain, misunderstood or might need modification? How do doctors talk with patients and families about these cases, and are there missed opportunities to improve such discussions?" Lo said. "By answering these questions, physicians can improve the quality of care for dying patients and their families irrespective of their views on euthanasia and physician-assisted suicide."

More information

The U.S. National Institute on Aging offers a guide on comfort and care for people nearing death.

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Little change in Dutch euthanasia post-legality

The frequency of doctor-assisted euthanasia in the Netherlands has changed little since the longstanding practice was legalized in 2002, according to a new study.

A summary published Wednesday on The Lancet magazine's website said that "in 2010, of all deaths in the Netherlands, 2.8 percent were the result of euthanasia. This is higher than the 1.7 percent in 2005, but comparable with (levels seen) in 2001 and 1995."

Under Dutch law, a person who asks to die may be administered a lethal mixture of sedatives and muscle relaxants if two doctors agree he or she is suffering "unbearable" pain with no prospect for recovery. Most cases involve cancer victims.

The Lancet study used data from the country's death registry and sent confidential questionnaires to doctors, extrapolating results to represent a cross-section of deaths in different social, medical and geographical areas. Researchers used the same methodology as in previous studies in 1990, 1995, 2001 and 2005.

Dutch doctors are also required to report all euthanasia cases on a non-confidential basis to the country's Euthanasia Commission, but that yields numbers that are widely believed to underreport the total number of euthanasia cases in the country.

All cases sent to the Euthanasia Commission are reviewed by a panel of experts, and some cases each year lead to official sanctions for doctors who fail to follow the rules, or even criminal prosecutions in a handful of cases.

According to commission data, there were 3,136 euthanasia cases in 2010, out of 136,000 deaths countrywide recorded by the Central Bureau for Statistics. That suggests a euthanasia rate of about 2.3 percent, less than the 2.8 percent found in the Lancet study. The total Dutch population is around 16.3 million.

"In the Netherlands, the euthanasia law resulted in a relatively transparent practice," wrote the Lancet study's lead author Bregje Onwuteaka-Philipsen. "Although translating these results to other countries is not straightforward, they can inform the debate on legalization of assisted dying in other countries."

One other noteworthy finding of the Lancet study was that the number of cases of "palliative sedation"

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