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Patients with somatic conditions more likely to be granted euthanasia

Patients who requested euthanasia or physician-assisted suicide were more likely to have their request granted if they had a somatic condition or cognitive decline, according to recently published data in JAMA Internal Medicine.

“During its first year, the End-of-Life Clinic granted approximately a quarter of requests for physician-assisted suicide and euthanasia and rejected slightly less than half, particularly requests that involved psychological issues,” the researchers wrote. 

In the Netherlands, End-of-Life Clinics provide euthanasia and physician-assisted suicide “to patients who meet the legal requirements but had their requests rejected by their regular physicians,” according to the study.

To assess trends in granted and rejected requests for euthanasia or physician-assisted suicide in End-of-Life Clinics, researchers analyzed data from 645 patient requests. 

Overall, 25.1% of euthanasia or physician-assisted suicide requests were granted. Three-hundred requests were denied (46.5%), 9.1% of requests were withdrawn and 19.2% of patients died before the request was reviewed.

Granted requests were significantly associated with somatic conditions and cognitive decline. Additionally, patients who were older, married and had children were more likely to have their requests granted. 

Among granted requests, 56.8% were performed by the clinic, 14.2% were performed by a regular physician and 29% were requests in which a regular physician agreed to perform euthanasia or physician-assisted suicide in the near future. 

Forty patients requested euthanasia or physician-assisted suicide because they were tired of living; 11 of these requests were granted. 

“Our findings suggest that physicians in the Netherlands have more reservations regarding less common reasons that patients request euthanasia and physician-assisted suicide than the medical staff working for the End-of-Life Clinic. The physicians and nurses employed by the clinic, however, often confirmed the assessment of the physician who previously cared for the patient; they rejected nearly half of the requests for euthanasia and physician-assisted suicide, possibly because the legal due care criteria had not been met,” the researchers wrote. – by Casey Hower

Disclosures: Snijdewind reports receiving financial support from the End-of-Life Clinic (Stichting Levenseindekliniek). The researchers report no other relevant financial disclosures.