Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.
ADVANCED SEARCH
Log in
Top
BMC Health Services Research
Published in: BMC Health Services Research 1/2009

Open Access 01-12-2009 | Research article

Establishing specialized health services for professional consultation in euthanasia: experiences in the Netherlands and Belgium

Authors: Yanna Van Wesemael, Joachim Cohen, Bregje D Onwuteaka-Philipsen, Johan Bilsen, Luc Deliens

Published in: BMC Health Services Research | Issue 1/2009

Login to get access

Abstract

Background

The Netherlands, Belgium, and Luxembourg have adopted laws decriminalizing euthanasia under strict conditions of prudent practice. These laws stipulate, among other things, that the attending physician should consult an independent colleague to judge whether the substantive criteria of due care have been met. In this context initiatives were taken in the Netherlands and Belgium to establish specialized services providing such consultants: Support and Consultation for Euthanasia in the Netherlands (SCEN) and Life End Information Forum (LEIF) in Belgium. The aim of this study is to describe and compare these initiatives.

Methods

We studied and compared relevant documents concerning the Dutch and Belgian consultation service (e.g. articles of bye-laws, inventories of activities, training books, consultation protocols).

Results

In both countries, the consultation services are delivered by trained physicians who can be consulted in cases of a request for euthanasia and who offer support and information to attending physicians. The context in which the two organisations were founded, as well as the way they are organised and regulated, is different in each country. By providing information on all end-of-life care matters, the Belgian LEIF seems to have a broader consultation role than the Dutch SCEN. SCEN on the other hand has a longer history, is more regulated and organised on a larger scale and receives more government funding than LEIF. The number of training hours for physicians is equal. However, SCEN-training puts more emphasis on the consultation report, whereas LEIF-training primarily emphasizes the ethical framework of end-of-life decisions.

Conclusion

In case of a request for euthanasia, in the Netherlands as well as in Belgium similar consultation services by independent qualified physicians have been developed. In countries where legalising physician-assisted death is being contemplated, the development of such a consultation provision could also be considered in order to safeguard the practice of euthanasia (as it can provide safeguards to adequate performance of euthanasia and assisted suicide).
Literature
1.
Bosshard G, Fischer S, Bär W: Open regulation and practice in assisted dying. Swiss Med Wkly. 2002, 132: 527-534.PubMed
2.
Giroud C, Augsburger M, Horisberger B, Lucchini P, Rivier L, Mangin P: Exit association-mediated suicide: toxicologic and forensic aspects. Am J Forensic Med Pathol. 1999, 20: 40-44. 10.1097/00000433-199903000-00010.CrossRefPubMed
3.
Steinbrook R: Physician-assisted death--from Oregon to Washington State. N Engl J Med. 2008, 359: 2513-2515. 10.1056/NEJMp0809394.CrossRefPubMed
4.
Law concerning euthanasia: Wet betreffende euthanasie, 28 mei 2002. Belgisch Staatsblad 2002 juni 2002 [Belgian official collection of the laws June 22 2002]. 2002, 2002009590.
5.
Termination of Life on Request and Assisted Suicide (Review Procedures) Act April 1 2(D): Wet toetsing levensbeeindiging op verzoek en hulp bij zelfdoding 1 april, 2002. 2002
6.
Law of March 16th 2009 on euthanasia and assisted suicide (in French): Loi du 16 mars 2009 sur l'euthanasie et l'assistance au suicide. Memorial Journal Officiel du Grand-Duche de Luxembourg. 2009, A - nr 46: 615-619.
7.
Smets T, Bilsen J, Cohen J, Rurup M, De Keyser E, Deliens L: The medical practice of euthanasie in Belgium and the Netherlands: Legal notification, control and evaluation procedures. Health Policy (New York). 2009, 90: 181-187.CrossRef
8.
Breitbart W, Rosenfeld B, Pessin H, Kaim M, Funesti-Esch J, Galietta M, Nelson CJ, Brescia R: Depression, hopelessness, and desire for hastened death in terminally ill patients with cancer. JAMA. 2000, 284: 2907-2911. 10.1001/jama.284.22.2907.CrossRefPubMed
9.
Chochinov HM, Wilson KG, Enns M, Lander S: Depression, Hopelessness, and suicidal ideation in the terminally ill. Psychosomatics. 1998, 39: 366-370.CrossRefPubMed
10.
Sand L, Strang P, Milberg A: Dying cancer patients' experiences of powerlessness and helplessness. Support Care Cancer. 2008, 16: 853-862. 10.1007/s00520-007-0359-z.CrossRefPubMed
11.
Deliens L, Wal van der G: The euthanasia law in Belgium and The Netherlands. Lancet. 2003, 362: 1239-1240. 10.1016/S0140-6736(03)14520-5.CrossRefPubMed
12.
Jansen-van der Weide M, Onwuteaka-Philipsen B, van der Wal G: Implementation of the project 'Support and Consultation on Euthanasia in the Netherlands' (SCEN). Health Policy (New York). 2004, 69: 365-373.CrossRef
13.
Distelmans W, Destrooper P, Bauwens S, De Maegd M, Gaer Van de K: Life End Information Forum (LEIF): professional advise and support at end-of-life issues. Psycho Oncology. 2008, 17 (6): 222.
14.
Onwuteaka-Philipsen B, Weide Jansen-van der M, Pasman H, Wal van der G: Support and Consultation on Euthanasia in the Netherlands. Evaluation and implementation of effects. [in Dutch]. 2003
15.
Royal Dutch Medical Association: Spiegelinformatie-yearly inventory. 2006
16.
Royal Dutch Medical Association: Spiegelinformatie-yearly inventory. 2005
17.
Royal Dutch Medical Association: Spiegelinformatie-yearly registration. 2004
18.
Royal Dutch Medical Association S: RDMA training for SCEN-physician [in Dutch], november 2008.
19.
Onwuteaka-Philipsen B, Wal van der G: A protocol for consultation of another physician in cases of euthanasia and assisted suicide. J Med Ethics. 2001, 27: 331-337. 10.1136/jme.27.5.331.CrossRefPubMed
20.
21.
22.
Life End Information Forum (LEIF) - Wim Distelmans: LEIFblad. 2008
23.
Distelmans W: LEIF: het LevensEinde InformatieForum (LEIF: the Life End Information Forum). Neuron. 2008, 13 (3): 144-146.
24.
Distelmans W, Bauwens S, Destrooper P: Life End Information Forum-physicians (LEIFartsen): Improvement of communication Skills in End-of-Life issues among physicians. Psycho Oncology. 2006, 15 (2 suppl): 226-227.
25.
Onwuteaka-Philipsen B, Wal van der G: Support and consultation for general practitioners concerning euthanasia: the SCEA project. Health Policy (New York). 2001, 56: 33-48.CrossRef
26.
Adams M: Euthanasia: the process of legal change in Belgium. Regulating physician-negotiated death. Edited by: Klijn A, Otlowski M, Trappenburg M. 2001, Gravenhage: Elsevier, 29-47.
27.
28.
29.
30.
Law concerning palliative care Belgium, June 14, 2002 (in Dutch): Wet betreffende palliatieve zorg 14 juni 2002. Belgisch Staatsblad 26 oktober 2002 [Belgian official collection of the laws June 22, 2002]. 2002, 2002022868.
31.
Law concerning patient rights in Belgium August 22 2(D: Wet betreffende de rechten van de patient 22 augustus 2002. Belgisch Staatsblad 26 september 2002 [Belgian official collection of the laws September 26 2002]. 2002, 2002022737.
32.
Hofstede G: Culture's Consequences. Comparing Values, Behaviors, Institutions, and Organizations Across Nations. 2001, London: Sage
33.
Onwuteaka-Philipsen B, Gevers J, Heide van der A, van Delden J, Pasman R, Rietjens J, Rurup M, Buiting H, Hanssen-de Wolf J, Maes van der P: Evaluatie Wet toetsing levensbeeindiging op verzoek en hulp bij zelfdoding. 2007, Den Haag: Zon/Mw
34.
Van Wesemael Y, Cohen J, Onwuteaka-Philipsen B, Bilsen J, Distelmans W, Deliens L: Role and involvement of Life End Information Forum physicians in euthanasia and other end-of-life care decisions in Flanders, Belgium. Health Serv Res. 2009.
35.
Federale Controle - en Evaluatiecommissie: Derde verslag aan de wetgevende kamers (2006-2007) [Federal Control and Evaluation Committee Euthanasia. Third report to Parliament (2006-2007)(in Dutch and French)]. 2007
Metadata
Title
Establishing specialized health services for professional consultation in euthanasia: experiences in the Netherlands and Belgium
Authors
Yanna Van Wesemael
Joachim Cohen
Bregje D Onwuteaka-Philipsen
Johan Bilsen
Luc Deliens
Publication date
01-12-2009
Publisher
BioMed Central
Published in
BMC Health Services Research / Issue 1/2009
Electronic ISSN: 1472-6963
DOI
https://doi.org/10.1186/1472-6963-9-220

Other articles of this Issue 1/2009

BMC Health Services Research 1/2009 Go to the issue

Research article

Participant observation of time allocation, direct patient contact and simultaneous activities in hospital physicians

Research article

Comparative study of paediatric prescription drug utilization between the spanish and immigrant population

Research article

Assessment of the multidisciplinary education for a major change in clinical practice; a prospective cohort study

Research article

Patient satisfaction with healthcare provided by family doctors: primary dimensions and an attempt at typology

Research article

An effectiveness analysis of healthcare systems using a systems theoretic approach

Research article

Racial differences in long-term adherence to oral antidiabetic drug therapy: a longitudinal cohort study