title: Ethics policies on euthanasia in hospitals--A survey in Flanders (Belgium).
abstract: OBJECTIVE
  To determine the prevalence, development, stance, and communication of written institutional ethics policies on euthanasia in Flemish hospitals.
  
  
  METHODS
  Cross-sectional mail survey of general directors of all hospitals (n=81) in Flanders, Belgium.
  
  
  RESULTS
  Of the 81 hospitals invited to participate, 71 (88%) completed the questionnaire. Of these, 45 (63%) had a written ethics policy on euthanasia. The Belgian Act on Euthanasia and centrally developed guidelines of professional organisations were the most frequently mentioned reasons for and sources used in developing ethics policies on euthanasia in hospitals. Up to one-third of hospitals reported that they developed the policy upon request from physicians or nurses, or after being confronted with a euthanasia request. Development and approval of institutional ethics policies occurred within a multidisciplinary context involving clinicians, ethicists, and hospital administrators. The majority of hospitals restrictively applied the euthanasia law by introducing palliative procedures in addition to legal due care criteria. Private Catholic hospitals, in particular, were more likely to be restrictive: euthanasia is not permitted or is permitted only in exceptional cases (in accordance with legal due care criteria and additional palliative care procedures). The majority of hospitals took the initiative to communicate the policy to hospital physicians and nurses.
  
  
  CONCLUSIONS
  Since the enactment of the Belgian Act on Euthanasia in 2002, the debate on how to deal with euthanasia requests has intensified in Flemish hospitals. The high prevalence of written institutional ethics policies on euthanasia and other medical end-of-life decisions is one possible outcome of this debate.
authors.affiliation: Centre for Biomedical Ethics and Law, Katholieke Universiteit Leuven, Kapucijnenvoer 35, B-3000 Leuven, Belgium. Joke.Lemiengre@med.kuleuven.be
authors.forename: Joke
authors.initials: J
authors.lastname: Lemiengre
authors.forename: Bernadette
authors.initials: B
authors.lastname: Dierckx de Casterlé
authors.forename: Geert
authors.initials: G
authors.lastname: Verbeke
authors.forename: Catherine
authors.initials: C
authors.lastname: Guisson
authors.forename: Paul
authors.initials: P
authors.lastname: Schotsmans
authors.forename: Chris
authors.initials: C
authors.lastname: Gastmans
mesh_terms: D001530:Belgium; D003430:Cross-Sectional Studies; D005065:Euthanasia / Q000941:ethics* / Q000331:legislation & jurisprudence; D006739:Hospital Administration; D006801:Humans; D016134:Organizational Policy; D011050:Policy Making; D011795:Surveys and Questionnaires