• Nicole Steck, Matthias Egger, Maud Maessen, Thomas Reisch, and Marcel Zwahlen.
• *Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland †School of Social and Community Medicine, University of Bristol, Bristol, UK ‡University Hospital of Psychiatry, Bern, Switzerland.
• Med Care. 2013 Oct 1;51(10):938-44.

BackgroundLegal in some European countries and US states, physician-assisted suicide and voluntary active euthanasia remain under debate in these and other countries.ObjectivesThe aim of the study was to examine numbers, characteristics, and trends over time for assisted dying in regions where these practices are legal: Belgium, Luxembourg, the Netherlands, Switzerland, Oregon, Washington, and Montana.DesignThis was a systematic review of journal articles and official reports. Medline and Embase databases were searched for relevant studies, from inception to end of 2012. We searched the websites of the health authorities of all eligible countries and states for reports on physician-assisted suicide or euthanasia and included publications that reported on cases of physician-assisted suicide or euthanasia. We extracted information on the total number of assisted deaths, its proportion in relation to all deaths, and socio-demographic and clinical characteristics of individuals assisted to die.ResultsA total of 1043 publications were identified; 25 articles and reports were retained, including series of reported cases, physician surveys, and reviews of death certificates. The percentage of physician-assisted deaths among all deaths ranged from 0.1%-0.2% in the US states and Luxembourg to 1.8%-2.9% in the Netherlands. Percentages of cases reported to the authorities increased in most countries over time. The typical person who died with assistance was a well-educated male cancer patient, aged 60-85 years.ConclusionsDespite some common characteristics between countries, we found wide variation in the extent and specific characteristics of those who died an assisted death.

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