How do hospitals deal with euthanasia requests in Flanders (Belgium)? A content analysis of policy documents.
OBJECTIVE
To describe the form and content of ethics policies on euthanasia in Flemish hospitals and the possible influence of religious affiliation on policy content.


METHODS
Content analysis of policy documents.


RESULTS
Forty-two documents were analyzed. All policies contained procedures; 57% included the position paper on which the hospital's stance on euthanasia was based. All policies described their hospital's stance on euthanasia in competent terminally ill patients (n=42); 10 and 4 policies, respectively, did not describe their stance in incompetent terminally and non-terminally ill patients. Catholic hospitals restrictively applied the euthanasia law with palliative procedures and interdisciplinary deliberations. The policies described several phases of the euthanasia care process--confrontation with euthanasia request (93%), decision-making process (95%), care process in cases of no-euthanasia decision (38%), preparation and performance of euthanasia (79%), and aftercare (81%)--as well as involvement of caregivers, patients, and relatives; ethical issues; support for caregivers; reporting; and practical examples of professional attitudes and communication skills.


CONCLUSIONS
Euthanasia policies go beyond summarizing the euthanasia law by addressing the importance of the euthanasia care process, in which palliative care and interdisciplinary cooperation are important factors.


CONCLUSIONS
Euthanasia policies provide tangible guidance for physicians and nurses on handling euthanasia requests.
Lemiengre
Joke
J
Centre for Biomedical Ethics and Law, Katholieke Universiteit Leuven, Leuven, Belgium. Joke.Lemiengre@med.kuleuven.be
Dierckx de Casterlé
Bernadette
B
Denier
Yvonne
Y
Schotsmans
Paul
P
Gastmans
Chris
C
D001530:Belgium; D002410:Catholicism; D016009:Chi-Square Distribution; D003659:Decision Making, Organizational; D004282:Documentation; D005065:Euthanasia / Q000941:ethics / Q000331:legislation & jurisprudence / Q000523:psychology; D017408:Guidelines as Topic; D006302:Health Services Research; D006742:Hospital Bed Capacity / Q000706:statistics & numerical data; D006769:Hospitals, General / Q000941:ethics / Q000458:organization & administration*; D016519:Hospitals, Religious / Q000941:ethics / Q000458:organization & administration*; D006782:Hospitals, Special / Q000941:ethics / Q000458:organization & administration*; D006801:Humans; D016743:Mental Competency; D009935:Organizational Affiliation / Q000941:ethics / Q000458:organization & administration; D016134:Organizational Policy; D010067:Ownership; D010342:Patient Acceptance of Health Care / Q000523:psychology; D010348:Patient Care Team / Q000458:organization & administration; D012069:Religion and Psychology; D013727:Terminal Care / Q000941:ethics / Q000458:organization & administration* / Q000523:psychology