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Active voluntary euthanasia or physician-assisted suicide?

B D Onwuteaka-Philipsen1, M T Muller, G van der Wal

  • 1Vrije Universiteit Amsterdam, Institute for Research in Extramural Medicine, The Netherlands.

Journal of the American Geriatrics Society
|November 5, 1997
PubMed
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Dutch physicians and patients choose active voluntary euthanasia over physician-assisted suicide primarily for medical reasons. Physician-assisted suicide is chosen for moral reasons, allowing patients to bear responsibility.

Area of Science:

  • Medical Ethics
  • End-of-Life Care

Background:

  • Distinguishes between euthanasia (intentional termination of life by another) and physician-assisted suicide (assisting a patient to self-terminate).
  • Examines decision-making factors in end-of-life choices within the Netherlands.

Purpose of the Study:

  • Investigate the reasons behind Dutch general practitioners (GPs) and nursing home physicians (NHPs), and patients' preferences for active voluntary euthanasia versus physician-assisted suicide.
  • Understand the influencing factors in selecting one end-of-life procedure over the other.

Main Methods:

  • Employs two descriptive, retrospective studies conducted in the Netherlands.
  • Utilizes anonymous questionnaires distributed to a random sample of 521 GPs and all 713 NHPs.
  • Data collection spanned from 1986-1989 for GPs and 1986-June 1990 for NHPs.
Keywords:
Death and EuthanasiaEmpirical Approach

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Main Results:

  • Physical condition of the patient was the primary driver for euthanasia in 48% of GP cases and 78% of NHP cases.
  • The desire for the patient to bear responsibility was the most cited reason for physician-assisted suicide.
  • Active voluntary euthanasia was often chosen due to patient condition, while physician-assisted suicide was chosen for moral reasons.

Conclusions:

  • In a significant percentage of cases (38% for GPs, 57% for NHPs), only active voluntary euthanasia was medically feasible due to the patient's condition.
  • When a choice existed, GPs leaned towards euthanasia, whereas NHPs favored assisted suicide.
  • Medico-technical reasons predominantly influenced the choice for active voluntary euthanasia, contrasting with the moral considerations for physician-assisted suicide.