Physician-Assisted Dying

Abstract

Two recent articles have again piqued our interest in the subject of physician-assisted suicide and euthanasia. As noted by Chambaere et al, Belgium and the Netherlands in 2002, and Luxemburg in 2009, have decriminalized physician-assisted suicide and euthanasia. The issue is currently being debated in Canada. Two states in the United States have legalized physician-assisted suicide, namely, Oregon in 1997 and Washington State in 2009. In addition, the Montana Supreme Court has recently ruled that state law protects doctors in Montana from prosecution for helping terminally ill patients die. As reported in the New York Times, the Court sidestepped the larger landmark issue of whether physicianassisted suicide is a right guaranteed under the state’s constitution. In 2007, Chambaere et al conducted a large scale study of death certificates in Flanders, Belgium, where euthanasia is legal. Flanders is the Dutch-speaking part of Belgium, which has about 6 million inhabitants and 55 000 deaths per year. A stratified sample of all death certificates from June to November 2007 was obtained consisting of 6927 death certificates. This represented 25% of deaths during the study period and approximately 12% of all deaths in Flanders in 2007. A 5-page questionnaire was sent to the attending physician in each case with 58.4% responding. Physicians were asked about end-of-life issues concerning the use of life-ending drugs with (assisted suicide or euthanasia) or without the patient’s explicit request. The investigators identified 208 assisted suicide or euthanasia deaths (weighed prevalence 2.0%) with an explicit request from the patient and 66 (weighted prevalence 1.8%) without an explicit request. The following is a summary of the patients’ characteristics and study results of the 2 groups: