title: Obligatory consultation of an independent physician on euthanasia requests in the Netherlands: what influences the SCEN physicians judgment of the legal requirements of due care?
abstract: BACKGROUND
  In the Netherlands, euthanasia is allowed if physicians adhere to legal requirements. Consultation of an independent physician is one of the requirements. SCEN (Support and Consultation on Euthanasia in the Netherlands) physicians have been trained to provide such consultations.
  
  
  OBJECTIVE
  To study why euthanasia requests are sometimes judged not to meet requirements of due care and to find out which characteristics are associated with the SCEN physicians' judgments.
  
  
  METHODS
  During 5 years (2006, 2008-2011) standardized registration forms were used for data-collection. We used multilevel logistic regression analysis to assess the associations of characteristics and SCEN physicians' judgments.
  
  
  RESULTS
  We analyzed 1631 euthanasia requests, involving 415 SCEN physicians. Patient characteristics that were associated with a lower likelihood to meet due care requirements were: being tired with life, depression and not wanting to be a burden. Physical suffering and higher patient age were related to greater chances of meeting the requirements. There was no clear association between SCEN physicians' characteristics and their judgment.
  
  
  CONCLUSIONS
  Psychological suffering involves a greater chance that SCEN physicians judge that requirements of due care are not met. The association between SCEN physician characteristics and the judgment of euthanasia requests is limited, suggesting uniformity in their judgment.
authors.affiliation: Erasmus MC, University Medical Center Rotterdam, Department of Public Health, Rotterdam, The Netherlands. Electronic address: a.brinkman-stoppelenburg@erasmusmc.nl.
authors.forename: Arianne
authors.initials: A
authors.lastname: Brinkman-Stoppelenburg
authors.affiliation: Erasmus MC, University Medical Center Rotterdam, Department of Public Health, Rotterdam, The Netherlands. Electronic address: y.vergouwe@erasmusmc.nl.
authors.forename: Yvonne
authors.initials: Y
authors.lastname: Vergouwe
authors.affiliation: Erasmus MC, University Medical Center Rotterdam, Department of Public Health, Rotterdam, The Netherlands. Electronic address: a.vanderheide@erasmusmc.nl.
authors.forename: Agnes
authors.initials: A
authors.lastname: van der Heide
authors.affiliation: VU University Medical Center, Department of Public and Occupational Health and EMGO Institute for Health and Care Research, VUmc Expertise Center for Palliative Care, Amsterdam, The Netherlands. Electronic address: b.philipsen@vumc.nl.
authors.forename: Bregje D
authors.initials: BD
authors.lastname: Onwuteaka-Philipsen
mesh_terms: D000367:Age Factors; D000368:Aged; D003430:Cross-Sectional Studies; D033101:Euthanasia, Active, Voluntary / Q000331:legislation & jurisprudence* / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D007600:Judgment; D008297:Male; D008875:Middle Aged; D009426:Netherlands; D010146:Pain / Q000453:epidemiology; D010820:Physicians / Q000331:legislation & jurisprudence / Q000706:statistics & numerical data; D012017:Referral and Consultation / Q000331:legislation & jurisprudence* / Q000706:statistics & numerical data; D011795:Surveys and Questionnaires; D013727:Terminal Care / Q000331:legislation & jurisprudence / Q000706:statistics & numerical data
keywords: Consultation; End-of-life decision-making; Euthanasia