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[Life-terminating actions by family practitioners and nursing home physicians without the patient's request]
M T Muller1, G van der Wal, M W Ribbe
1Vrije Universiteit, vakgroep Huisarts- en Verpleeghuisgeneeskunde, Amsterdam.
Objective:
To describe deliberate and active termination of life without the patient's request by general practitioners and Dutch 'nursing home' physicians.
Design:
Descriptive, retrospective investigation.
Method:
Data were collected through anonymous postal questionnaires sent to a random sample of 521 general practitioners in North Holland and 521 general practitioners in the rest of the Netherlands regarding 1986-1989 and to all 713 Dutch 'nursing home' physicians affiliated to the Dutch Association of Nursing Home Physicians regarding 1986-June 1990.
Results:
65 General practitioners (10%) and 28 nursing home physicians (5%) had at any time deliberately terminated the life of a patient without explicit request by the patient, 94 and 70 times, respectively. In almost all cases the general practitioners indicated that the patients were suffering intensely; the nursing home physicians indicated this in 65% of the cases; with 66% and 57% of the patients contact was not possible; in 50% and in 65% of the cases, respectively, the family was involved in the decision to terminate the patient's life.
Conclusion:
Termination of life without request by the patient occurs in the practices of Dutch general practitioners and Dutch 'nursing home' physicians, but is rare.