Requests for euthanasia in general practice before and after implementation of the Dutch Euthanasia Act.

Area of Science:

• Medical Ethics
• Public Health Policy
• End-of-Life Care Research

Background:

• The Netherlands legalized euthanasia in 2002, becoming the first country globally to do so.
• The impact of this legislation on the frequency and nature of euthanasia requests remains under investigation.

Purpose of the Study:

• To analyze changes in the number and reasons for euthanasia requests in Dutch general practices post-Euthanasia Act implementation.
• To compare euthanasia request data from the five years preceding and succeeding the Act's enactment.

Main Methods:

• A retrospective dynamic cohort study design was employed.
• Data were collected using standardized registration forms from the Dutch Sentinel Practice Network, a nationally representative sample of 45 general practices.
• The study compared data from 1998-2002 (pre-Act) with 2003-2007 (post-Act).

Main Results:

• The overall annual incidence of euthanasia requests slightly decreased from 3.1 to 2.8 per 10,000 patients.
• Requests from males significantly decreased, while requests from females showed a non-significant increase.
• Cancer remained the primary underlying condition for requests; pain decreased as a reason post-implementation, and loss of dignity significantly declined, especially among females.

Conclusions:

• The implementation of the Euthanasia Act did not lead to an increased demand for euthanasia.
• Trends in reasons for euthanasia requests shifted, with pain becoming less cited and loss of dignity significantly decreasing, particularly for women.