title: Development and communication of written ethics policies on euthanasia in Catholic hospitals and nursing homes in Belgium (Flanders).
abstract: OBJECTIVE
  To describe whether and how Catholic hospitals and nursing homes in Belgium (Flanders) have developed written ethics policies on euthanasia and communicated these policies to their employees, patients, and patient's relatives.
  
  
  METHODS
  A cross-sectional mail survey of general directors of Catholic hospitals and nursing homes in Belgium (Flanders).
  
  
  RESULTS
  Of the 298 targeted institutions, 81% of hospitals and 62% of nursing homes returned complete questionnaires. A high percentage of Catholic hospitals (79%) and a moderate percentage of nursing homes (30%) had written ethics policies on euthanasia. Both caregivers and healthcare administrators were involved in the development and approval of these policies. Physicians and nurses were best informed about the policies. More than half of the nursing homes (57%) took the initiative to inform both residents and relatives about the policies, while only one hospital did so.
  
  
  CONCLUSIONS
  The high prevalence of written ethics policies on euthanasia in Flemish Catholic hospitals may reflect the concern of healthcare administrators to maintain the quality of care for patients requesting euthanasia. However, the true contribution of these policies to quality end-of-life care and to supporting caregivers remains unknown and needs further research.
  
  
  CONCLUSIONS
  Legislation and centrally developed guidelines might influence healthcare institutions to develop ethics policies.
authors.affiliation: Centre for Biomedical Ethics and Law, Faculty of Medicine, Catholic University of Leuven, Belgium. Chris.Gastmans@med.kuleuven.be
authors.forename: Chris
authors.initials: C
authors.lastname: Gastmans
authors.forename: Joke
authors.initials: J
authors.lastname: Lemiengre
authors.forename: Bernadette Dierckx
authors.initials: BD
authors.lastname: de Casterlé
mesh_terms: D001291:Attitude of Health Personnel; D001530:Belgium; D002410:Catholicism; D003142:Communication; D003430:Cross-Sectional Studies; D003659:Decision Making, Organizational; D005065:Euthanasia / Q000941:ethics*; D005190:Family; D017408:Guidelines as Topic; D006270:Health Facility Administrators / Q000523:psychology; D006282:Health Personnel / Q000193:education; D006302:Health Services Research; D016519:Hospitals, Religious / Q000941:ethics / Q000458:organization & administration; D006801:Humans; D033181:Information Dissemination; D007318:Inservice Training; D007400:Interprofessional Relations; D009042:Motivation; D009735:Nursing Homes / Q000941:ethics / Q000458:organization & administration; D016134:Organizational Policy; D010353:Patient Education as Topic; D016730:Program Development; D011795:Surveys and Questionnaires; D013727:Terminal Care / Q000941:ethics / Q000458:organization & administration