title: Physician-assisted dying for children is conceivable for most Dutch paediatricians, irrespective of the patient's age or competence to decide.
abstract: OBJECTIVE
  Paediatricians caring for severely ill children may receive requests for physician-assisted dying (PAD). Dutch euthanasia law only applies to patients over 12 who make well-considered requests. These limitations have been widely debated, but little is known about paediatricians' positions on PAD. We explored the situations in which paediatricians found PAD conceivable and described the roles of the patient and parents, the patient's age and their life expectancy.
  
  
  METHODS
  We sent a questionnaire to a national sample of 276 Dutch paediatricians and carried out semi-structured interviews with eight paediatricians.
  
  
  RESULTS
  The response rate was 62%. Most paediatricians said performing PAD on request was conceivable (81%), conceivability was independent of the patient's age and whether the patient or parent(s) requested it. The paediatricians interviewed felt a duty to relieve suffering, irrespective of the patient's age or competency to decide. When this was not possible through palliative care, PAD was seen as an option for all patients who were suffering unbearably, although some paediatricians saw parental agreement and reduced life expectancy as prerequisites.
  
  
  CONCLUSIONS
  Most Dutch paediatricians felt PAD was conceivable, even under the age of 12 if requested by the parents. They seemed driven by a sense of duty to relieve suffering.
authors.affiliation: Department of Public and Occupational Health, EMGO Institute for Health and Care Research, VUmc Expertise Centre for Palliative Care, VU University Medical Center, Amsterdam, The Netherlands.
authors.forename: Eva Elizabeth
authors.initials: EE
authors.lastname: Bolt
authors.affiliation: Department of Public and Occupational Health, EMGO Institute for Health and Care Research, VUmc Expertise Centre for Palliative Care, VU University Medical Center, Amsterdam, The Netherlands.
authors.forename: Eva Quirien
authors.initials: EQ
authors.lastname: Flens
authors.affiliation: Department of Public and Occupational Health, EMGO Institute for Health and Care Research, VUmc Expertise Centre for Palliative Care, VU University Medical Center, Amsterdam, The Netherlands.
authors.forename: H Roeline Willemijn
authors.initials: HR
authors.lastname: Pasman
authors.affiliation: Section of Medical Ethics, Department of General Practice, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.
authors.forename: Dick
authors.initials: D
authors.lastname: Willems
authors.affiliation: Department of Public and Occupational Health, EMGO Institute for Health and Care Research, VUmc Expertise Centre for Palliative Care, VU University Medical Center, Amsterdam, The Netherlands.
authors.forename: Bregje Dorien
authors.initials: BD
authors.lastname: Onwuteaka-Philipsen
mesh_terms: D000328:Adult; D000367:Age Factors; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010372:Pediatrics / Q000706:statistics & numerical data*; D017236:Suicide, Assisted / Q000523:psychology*
keywords: Dutch Euthanasia Law; Euthanasia; Life expectancy; Physician-assisted dying; Suffering; Terminally ill children