Opinions of health care professionals and the public after eight years of euthanasia legislation in the Netherlands: a mixed methods approach.
BACKGROUND
The practice of euthanasia and physician-assisted suicide (PAS) in the Netherlands has been regulated since 2002 by the Euthanasia Act. In the ongoing debate about the interpretation of this Act, comparative information about the opinions of the different stakeholders is needed.


OBJECTIVE
To evaluate the opinions of Dutch physicians, nurses and the general public on the legal requirements for euthanasia and PAS.


METHODS
A cross-sectional survey among Dutch physicians and nurses in primary and secondary care and members of the Dutch general public, followed by qualitative interviews among selected respondents. The participants were: 793 physicians, 1243 nurses and 1960 members of the general public who completed the questionnaire; 83 were interviewed.


RESULTS
Most respondents agreed with the requirement of a patient request (64-88%) and the absence of a requirement concerning life expectancy (48-71%). PAS was thought acceptable by 24-39% of respondents for patients requesting it because of mental suffering due to loss of control, chronic depression or early dementia. In the case of severe dementia, one third of physicians, 58% of nurses and 77% of the general public agreed with performing euthanasia based on an advance directive. Interviewees illustrated these findings and supported the Act.


CONCLUSIONS
Health care professionals and the general public mostly support the legal requirements for euthanasia and PAS. The law permits euthanasia or PAS for mental suffering but this possibility is not widely endorsed. The general public is more liberal towards euthanasia for advanced dementia than health care professionals. We conclude that there is ample support for the law after eight years of legal euthanasia.
Julius Center, University Medical Center Utrecht, The Netherlands. P.S.C.Kouwenhoven@umcutrecht.nl
Pauline S C
PS
Kouwenhoven
Natasja J H
NJ
Raijmakers
Johannes J M
JJ
van Delden
Judith A C
JA
Rietjens
Maartje H N
MH
Schermer
Ghislaine J M W
GJ
van Thiel
Margo J
MJ
Trappenburg
Suzanne
S
van de Vathorst
Bea J
BJ
van der Vegt
Cristiano
C
Vezzoni
Heleen
H
Weyers
Donald G
DG
van Tol
Agnes
A
van der Heide
D001291:Attitude of Health Personnel; D003430:Cross-Sectional Studies; D005065:Euthanasia / Q000331:legislation & jurisprudence*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009426:Netherlands; D011639:Public Opinion; D036301:Qualitative Research; D011795:Surveys and Questionnaires