title: Expressed wishes and incidence of euthanasia in advanced lung cancer patients.
abstract: This study explores expressed wishes and requests for euthanasia (i.e. administration of lethal drugs at the explicit request of the patient), and incidence of end-of-life decisions with possible life-shortening effects (ELDs) in advanced lung cancer patients in Flanders, Belgium. We performed a prospective, longitudinal, observational study of a consecutive sample of advanced lung cancer patients and selected those who died within 18 months of diagnosis. Immediately after death, the pulmonologist/oncologist and general practitioner (GP) of the patient filled in a questionnaire. Information was available for 105 out of 115 deaths. According to the specialist or GP, one in five patients had expressed a wish for euthanasia; and three in four of these had made an explicit and repeated request. One in two of these received euthanasia. Of the patients who had expressed a wish for euthanasia but had not made an explicit and repeated request, none received euthanasia. Patients with a palliative treatment goal at inclusion were more likely to receive euthanasia. Death was preceded by an ELD in 62.9% of patients. To conclude, advanced lung cancer patients who expressed a euthanasia wish were often determined. Euthanasia was performed significantly more among patients whose treatment goal after diagnosis was exclusively palliative.
authors.affiliation: End-of-life Care Research group, Ghent University and Vrije Universiteit Brussel, Laarbeeklaan 103, 1090 Brussels, Belgium. koen.pardon@vub.ac.be
authors.forename: Koen
authors.initials: K
authors.lastname: Pardon
authors.forename: Reginald
authors.initials: R
authors.lastname: Deschepper
authors.forename: Robert
authors.initials: R
authors.lastname: Vander Stichele
authors.forename: Jan L
authors.initials: JL
authors.lastname: Bernheim
authors.forename: Freddy
authors.initials: F
authors.lastname: Mortier
authors.forename: Denis
authors.initials: D
authors.lastname: Schallier
authors.forename: Paul
authors.initials: P
authors.lastname: Germonpré
authors.forename: Daniella
authors.initials: D
authors.lastname: Galdermans
authors.forename: Willem
authors.initials: W
authors.lastname: Van Kerckhoven
authors.forename: Luc
authors.initials: L
authors.lastname: Deliens
mesh_terms: D000368:Aged; D002289:Carcinoma, Non-Small-Cell Lung; D005065:Euthanasia / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008175:Lung Neoplasms; D008297:Male; D017533:Marital Status / Q000706:statistics & numerical data; D008875:Middle Aged; D010166:Palliative Care / Q000706:statistics & numerical data; D010347:Patient Care Planning; D057240:Patient Preference / Q000706:statistics & numerical data*; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D011446:Prospective Studies