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End-of-Life Decisions in the Netherlands over 25 Years

In a letter to the Editor of the New England Journal of Medicine (2017;377:492-494) the three main researchers of the Dutch euthanasia practice published a comprehensive summary of 25 years of Dutch End-of-Life decisions.

In the 6 surveys since 1990 a number of developments in the practice could be explained. From 1990 to 2015:

  • % dying preceded by end-of-life decision increased from 39% to 58%
  • % euthanasia increased from 1,7% of all deaths to 4,5%
  • % termination of life without request diminished from 0,8% to 0,3%
  • % use of morphine (for alleviating pain) increased from 19% to 36%

For more statistical material, visit the article on the NEJM website.

They concluded: The use of potentially life-shortening medication and continuous deep sedation to relieve end-of-life suffering has become common practice in the Netherlands. The frequency of physician assistance in dying is similar to the rate that was recently reported in Belgium, which is one of the few countries in which physician assistance in dying is also allowed. About half of all requests for physician assistance in dying were granted in 2015. Such assistance is provided predominantly to patients with severe disease but increasingly involves older patients and those with a life expectancy of more than a month.

 See table with all numbers:

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