Attitudes and practices of physicians regarding physician-assisted dying in minors.

Abstract

OBJECTIVE:

To investigate attitudes towards physician-assisted death in minors among all physicians involved in the treatment of children dying in Flanders, Belgium over an 18-month period, and how these are related to actual medical end-of-life practices.

DESIGN:

Anonymous population-based postmortem physician survey.

SETTING:

Flanders, Belgium.

PARTICIPANTS:

Physicians signing death certificates of all patients aged 1-17 years who died between June 2007 and November 2008.

MAIN OUTCOME MEASURES:

Attitudes towards physician-assisted death in minors and actual end-of-life practices in the deaths concerned.

RESULTS:

124 physicians for 70.5% of eligible cases (N=149) responded. 69% favour an extension of the Belgian law on euthanasia to include minors, 26.6% think this should be done by establishing clear age limits and 61% think parental consent is required before taking life-shortening decisions. Cluster analysis yielded a cluster (67.7% of physicians) accepting of, and a cluster (32.2% of physicians) reluctant towards physician-assisted death in minors. Controlling for physician specialty and patient characteristics, acceptant physicians were more likely to engage in practices with the intention of shortening a patient's life than were reluctant physicians.

CONCLUSION:

A majority of surveyed Flemish physicians appear to accept physician-assisted dying in children under certain circumstances and favour an amendment to the euthanasia law to include minors. The approach favoured is one of assessing decision-making capacity rather than setting arbitrary age limits. These stances, and their connection with actual end-of-life practices, may encourage policy-makers to develop guidelines for medical end-of-life practices in minors that address specific challenges arising in this patient group.

• Authors: Geert Pousset, Freddy Mortier, Johan Bilsen, Joachim Cohen, Luc Deliens
• Journal: Archives of disease in childhood (Arch Dis Child) Vol. 96 Issue 10 Pg. 948-53 (Oct 2011) ISSN: 1468-2044 [Electronic] England
• PMID: 20573739 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)

Topics

• Adolescent
• Attitude of Health Personnel
• Belgium
• Child
• Child, Preschool
• Decision Making
• Ethics, Medical
• Euthanasia, Active (ethics, legislation & jurisprudence, psychology)
• Female
• Humans
• Infant
• Male
• Mental Competency
• Minors
• Parental Consent
• Patient Participation
• Professional Practice (statistics & numerical data)
• Terminal Care (ethics, legislation & jurisprudence, psychology)