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Policy statements and practice guidelines for medical end-of-life decisions in Dutch health care institutions: Developments in the past decade

Author

Listed:
  • Pasman, H. Roeline W.
  • Wolf, Johanna E. Hanssen-de
  • Hesselink, Berniek A.M.
  • van der Heide, Agnes
  • van der Wal, Gerrit
  • van der Maas, Paul J.
  • Onwuteaka-Philipsen, Bregje D.

Abstract

Objectives To describe the existence of policy statements on euthanasia and physician-assisted suicide (EAS) and practice guidelines for all medical end-of-life decisions in Dutch health care institutions in 2005, whether the existence of practice guidelines is related to characteristics of institutions, and to compare the existence of policies in 2005 and 1994.Methods Questionnaires were sent to 566 institutions (all Dutch hospitals, nursing homes, general psychiatric hospitals, institutions for the mentally disabled, hospices) from October 2005 through March 2006.Results Most institutions (70%) had a written policy statement concerning EAS. EAS was usually allowed under specific conditions (75%). Institutions mainly had practice guidelines for EAS and do-not-resuscitate decisions (62% and 63%). A minority had guidelines on palliative sedation (27%), alleviation of symptoms (27%) and withdrawing or withholding treatment (33%). In general, there were more practice guidelines in 2005 than in 1994. Larger institutions and institutions with an ethics committee more often had practice guidelines. Religious affiliation of an institution did not seem to be related to the existence of guidelines.Conclusions Since many institutions still do not have practice guidelines for medical end-of-life decisions, they should be stimulated to introduce practice guidelines, being a first step in improving the quality of the care on institutional level.

Suggested Citation

  • Pasman, H. Roeline W. & Wolf, Johanna E. Hanssen-de & Hesselink, Berniek A.M. & van der Heide, Agnes & van der Wal, Gerrit & van der Maas, Paul J. & Onwuteaka-Philipsen, Bregje D., 2009. "Policy statements and practice guidelines for medical end-of-life decisions in Dutch health care institutions: Developments in the past decade," Health Policy, Elsevier, vol. 92(1), pages 79-88, September.
    • Handle: RePEc:eee:hepoli:v:92:y:2009:i:1:p:79-88
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    References listed on IDEAS

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    1. Lemiengre, Joke & Casterle, Bernadette Dierckx de & Verbeke, Geert & Guisson, Catherine & Schotsmans, Paul & Gastmans, Chris, 2007. "Ethics policies on euthanasia in hospitals--A survey in Flanders (Belgium)," Health Policy, Elsevier, vol. 84(2-3), pages 170-180, December.
    2. Lemiengre, Joke & de Casterle, Bernadette Dierckx & Van Craen, Katleen & Schotsmans, Paul & Gastmans, Chris, 2007. "Institutional ethics policies on medical end-of-life decisions: A literature review," Health Policy, Elsevier, vol. 83(2-3), pages 131-143, October.
    3. Bilsen, Johan & Vander Stichele, Robert & Broeckaert, Bert & Mortier, Freddy & Deliens, Luc, 2007. "Changes in medical end-of-life practices during the legalization process of euthanasia in Belgium," Social Science & Medicine, Elsevier, vol. 65(4), pages 803-808, August.
    4. Gastmans, Chris & Lemiengre, Joke & van der Wal, Gerrit & Schotsmans, Paul & Dierckx de Casterle, Bernadette, 2006. "Prevalence and content of written ethics policies on euthanasia in Catholic healthcare institutions in Belgium (Flanders)," Health Policy, Elsevier, vol. 76(2), pages 169-178, April.
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    Cited by:

    1. Close, Eliana & Willmott, Lindy & White, Ben P, 2021. "Regulating voluntary assisted dying practice: A policy analysis from Victoria, Australia," Health Policy, Elsevier, vol. 125(11), pages 1455-1474.
    2. Hesselink, Berniek A.M. & Pasman, H. Roeline W. & van der Wal, Gerrit & van der Maas, Paul J. & van der Heide, Agnes & Onwuteaka-Philipsen, Bregje D., 2010. "Development and dissemination of institutional practice guidelines on medical end-of-life decisions in Dutch health care institutions," Health Policy, Elsevier, vol. 94(3), pages 230-238, March.

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