Abstract

BackgroundIn Belgium law prohibits euthanasia at the end stage of dementia when patients are no longer able to formulate their will. The number of applications for euthanasia based on dementia is low, but patients and their relatives are searching for access to euthanasia.AimThis study assessed the opinions of GPs facing requests for euthanasia in patients with dementia.Design & settingA cross-sectional survey was performed in general practice. Flemish GPs were invited by email to participate in the study.MethodGPs were reached through the regional GP association and the online survey was open for 4 weeks. The data were then anonymised, analysed, and interpreted. The outcome of interest addresses opinions of Flemish GPs regarding euthanasia in patients with dementia.ResultsA total of 113/308 doctors participated. It was found that 69% agreed that euthanasia in patients without dementia is more acceptable than in patients with dementia. When patients with dementia had concomitant diseases, 59% stated that euthanasia was more acceptable than when patients were ‘healthy’. It was also found that 56% agreed the euthanasia law needs adjustments towards patients with dementia. Legal adjustments were supported more by GPs of a younger generation. Non-religious doctors were twice as likely to be in favour of legal adjustments than their religious colleagues; 51% believed that the ability of patients to repeat their will is essential; while 72% of GPs feared pressure from relatives to follow the declaration of will.ConclusionThe Belgian GP has an open attitude towards euthanasia for patients with dementia. There was a willingness to perform euthanasia as the stage of dementia worsened and in cases of terminal conditions. Debate, education, and experience will influence opinion and the legislation process.

Highlights

  • In Belgium, as in many other countries, the law prohibits euthanasia when patients with dementia lack the cognitive capability to express their will

  • It was found that 69% agreed that euthanasia in patients without dementia is more acceptable than in patients with dementia

  • When patients with dementia had concomitant diseases, 59% stated that euthanasia was more acceptable than when patients were ‘healthy’

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Summary

Introduction

In Belgium, as in many other countries, the law prohibits euthanasia when patients with dementia lack the cognitive capability to express their will. As these patients are no longer able to formulate a clear, voluntary, well-c­ onsidered, and sustainable request for euthanasia, legislation does not allow the euthanasia procedure to be carried out in Belgium.[1] the number of applications for Cleemput J and Schoenmakers B. Research euthanasia based on dementia is still low both in Belgium and in the Netherlands, patients and their relatives are increasingly searching for access to euthanasia.[2,3,4]. The number of applications for euthanasia based on dementia is low, but patients and their relatives are searching for access to euthanasia

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