| ISSUE SUMMARY |
| Disabilities Ethical History International Medical Psychological Religious |
Australia Euthanasia advocates work to make suicide easy. Belgium Canada England Germany Netherlands Killing Babies, Compassionately. The Netherlands follows in Germany’s footsteps. Seduced by Death: Doctors, Patients, and Assisted Suicide The Slippery Slope: The Dutch Example New Zealand Switzerland Assisted Suicide and Euthanasia in Switzerland Assisted-Suicide in Switzerland |
Clinical Problems With the Performance of Euthanasia and Physician-Assisted Suicide in the Netherlands Johanna H. Groenewoud et al., Clinical Problems with the Performance of Euthanasia and Physician-Assisted Suicide in the Netherlands, 342 New Eng. J. Med. 551 (2000)The characteristics and frequency of clinical problems with the performance of euthanasia and physician-assisted suicide are uncertain. The authors analyzed data from two studies of euthanasia and physician-assisted suicide in the Netherlands, with a total of 649 cases. Clinical problems were characterized as technical problems, such as difficulty inserting an intravenous line; complications, such as myoclonus or vomiting; or problems with completion, such as longer-than-expected interval between the administration of medications and death. Technical problems occurred in thirty-five cases (5%), complications in twenty-four cases (4%), and problems in completion in forty-four cases (7%). In ten cases, more than one type of problem occurred. Assisted suicide was more frequently associated with each type of problem than was euthanasia. General practitioners and nursing home physicians were more likely than specialists to report technical problems and problems with completion. Oral or rectal administration of medications was more likely than parenteral administration to be associated with technical problems. The most common technical problems were difficulty finding a vein in which to inject the drug and difficulty administering an oral medication. The most frequently mentioned complications were spasm or myoclonus and nausea or vomiting. The most common problems with completion were a longer-than expected interval between the administration of medications and death and failure to induce a comatose state. In twenty-one of the cases in which the intention had been to provide assistance with suicide, the physician administered the lethal drug. In twelve of these cases, a problem with completion was mentioned as the reason for the physician's intervention: the interval between the administration of medication and the occurrence of coma or death was too long (in nine cases), the patient did not become comatose after taking the first drug (in one case), or the patient awoke from coma (in two cases). In five other cases, the physician intervened because the patient had difficulty taking all the oral medication; for example, one patient vomited after taking the first medication, and one patient fell asleep before taking all the medication. In four cases, no specific reason for the physician's intervention was given. The authors conclude that there may be clinical problems with the performance of euthanasia and physician-assisted suicide. In the Netherlands, physicians who intend to provide assistance with suicide sometimes end up administering a lethal medication themselves because of the patient's inability to take the medication or because of problems with the completion of physician-assisted suicide. Posted on June 26, 2004. |