Physicians' willingness to grant requests for assistance in dying for children: a study of hypothetical cases.
OBJECTIVE
To study the willingness of Dutch physicians to use potentially life-shortening or lethal drugs for severely ill children.


METHODS
We asked 63 pediatricians about their approach to 10 hypothetical cases of children with cancer. The age of the child (15, 11, or 6 years), the child's (explicit) request, and the opinion of the parents varied. Two hypothetical cases were also presented to 125 general practitioners and 208 clinical specialists.


RESULTS
Most pediatricians were willing to increase morphine in all cases. A total of 48% to 60% of pediatricians were willing to use lethal drugs in children at the child's request, when the parents agreed; when parents requested ending of life of their unconscious child, 37% to 42% of pediatricians were willing; 13% to 28% of pediatricians were willing when parents did not agree with their child's request. General practitioners and clinical specialists were as willing as pediatricians to use lethal drugs at the child's request, but less willing to grant a request of parents for their unconscious child.


CONCLUSIONS
Many Dutch pediatricians are willing to use potentially life-shortening or lethal drugs for children. The legal limit of 12 years, as the age under which voluntary euthanasia is forbidden, is not fully supported by Dutch physicians.
Vrakking
Astrid M
AM
Department of Public Health, Room Ee2079, Erasmus MC, University Medical Center, PO Box 1738, 3000 DR Rotterdam, The Netherlands. a.vrakking@erasmusmc.nl
van der Heide
Agnes
A
Looman
Caspar W N
CW
van Delden
Johannes J M
JJ
Onwuteaka-Philipsen
Bregje D
BD
van der Maas
Paul J
PJ
van der Wal
Gerrit
G
D000293:Adolescent; D000328:Adult; D001291:Attitude of Health Personnel; D002648:Child; D005065:Euthanasia / Q000331:legislation & jurisprudence / Q000523:psychology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009020:Morphine / Q000008:administration & dosage*; D009369:Neoplasms / Q000145:classification / Q000523:psychology*; D009426:Netherlands; D010290:Parents / Q000523:psychology*; D010372:Pediatrics; D012720:Severity of Illness Index
D009020:Morphine