Euthanasia in Belgium: trends in reported cases between 2003 and 2013.
BACKGROUND
In 2002, the Belgian Act on Euthanasia came into effect, regulating the intentional ending of life by a physician at the patient's explicit request. We undertook this study to describe trends in officially reported euthanasia cases in Belgium with regard to patients' sociodemographic and clinical profiles, as well as decision-making and performance characteristics.


METHODS
We used the database of all euthanasia cases reported to the Federal Control and Evaluation Committee on Euthanasia in Belgium between Jan. 1, 2003, and Dec. 31, 2013 (n = 8752). The committee collected these data with a standardized registration form. We analyzed trends in patient, decision-making and performance characteristics using a χ2technique. We also compared and analyzed trends for cases reported in Dutch and in French.


RESULTS
The number of reported euthanasia cases increased every year, from 235 (0.2% of all deaths) in 2003 to 1807 (1.7% of all deaths) in 2013. The rate of euthanasia increased significantly among those aged 80 years or older, those who died in a nursing home, those with a disease other than cancer and those not expected to die in the near future (p < 0.001 for all increases). Reported cases in 2013 most often concerned those with cancer (68.7%) and those under 80 years (65.0%). Palliative care teams were increasingly often consulted about euthanasia requests, beyond the legal requirements to do so (p < 0.001). Among cases reported in Dutch, the proportion in which the person was expected to die in the foreseeable future decreased from 93.9% in 2003 to 84.1% in 2013, and palliative care teams were increasingly consulted about the euthanasia request (from 34.0% in 2003 to 42.6% in 2013). These trends were not significant for cases reported in French.


CONCLUSIONS
Since legalization of euthanasia in Belgium, the number of reported cases has increased each year. Most of those receiving euthanasia were younger than 80 years and were dying of cancer. Given the increases observed among non-terminally ill and older patients, this analysis shows the importance of detailed monitoring of developments in euthanasia practice.
End-of-Life Care Research Group (Dierickx, Deliens, Cohen, Chambaere), Vrije Universiteit Brussel, Brussels, and Ghent University, Ghent, Belgium; Department of Medical Oncology (Deliens), Ghent University Hospital, Ghent, Belgium sigrid.dierickx@vub.ac.be.
Sigrid
S
Dierickx
End-of-Life Care Research Group (Dierickx, Deliens, Cohen, Chambaere), Vrije Universiteit Brussel, Brussels, and Ghent University, Ghent, Belgium; Department of Medical Oncology (Deliens), Ghent University Hospital, Ghent, Belgium.
Luc
L
Deliens
End-of-Life Care Research Group (Dierickx, Deliens, Cohen, Chambaere), Vrije Universiteit Brussel, Brussels, and Ghent University, Ghent, Belgium; Department of Medical Oncology (Deliens), Ghent University Hospital, Ghent, Belgium.
Joachim
J
Cohen
End-of-Life Care Research Group (Dierickx, Deliens, Cohen, Chambaere), Vrije Universiteit Brussel, Brussels, and Ghent University, Ghent, Belgium; Department of Medical Oncology (Deliens), Ghent University Hospital, Ghent, Belgium.
Kenneth
K
Chambaere
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001530:Belgium; D016208:Databases, Factual; D003657:Decision Making; D033101:Euthanasia, Active, Voluntary / Q000331:legislation & jurisprudence* / Q000706:statistics & numerical data* / Q000639:trends*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012017:Referral and Consultation / Q000639:trends*; D011795:Surveys and Questionnaires; D055815:Young Adult