• Judith A C Rietjens, Johan Bilsen, Susanne Fischer, Agnes Van Der Heide, Paul J Van Der Maas, Guido Miccinessi, Michael Norup, Bregje D Onwuteaka-Philipsen, Astrid M Vrakking, and Gerrit Van Der Wal.
• Erasmus MC, University Medical Center Rotterdam, Department of Public Health, Erasmus MC, P.O. Box 2040, 3000CA Rotterdam, The Netherlands, j.rietjens@erasmusmc.nl
• Death Stud. 2007 Mar 1;31(3):205-21.

AbstractA small proportion of deaths result from the use of drugs with the intention to hasten death without an explicit request of the patient. Additional insight into its characteristics is needed for evaluating this practice. In the Netherlands in 2001, questionnaires were mailed to physicians that addressed the decision making that preceded their patient's death. Cases of ending life without an explicit request of the patient were compared with similar cases from 1995 and with cases from Belgium, Denmark, and Switzerland. In the Netherlands in 2001, patients receiving life-ending drugs without their explicit request were most often 80+ years old and had cancer. Most of them were incompetent patients nearing death. Characteristics of this practice in 1995 were quite comparable, as were characteristics of this practice in Belgium, Denmark, and Switzerland. The use of drugs with the intention to hasten death without an explicit request of the patient is part of medical end-of-life practice in the studied countries, regardless of their legal framework, and it occurs in similar fashion.

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