Attitudes and practices of physicians regarding physician-assisted dying in minors. Issue 10 (23rd June 2010)

• Record Type: Journal Article
• Authors: Pousset, Geert; Mortier, Freddy; Bilsen, Johan; Cohen, Joachim; Deliens, Luc
• Is Part Of: Archives of disease in childhood. Volume 96:Issue 10(2011)
• Page Start: 948
• Page End: 953
• Publication Date: 2010-06-23
• Subjects: Children -- Diseases -- Periodicals; Infants -- Diseases -- Periodicals; 618.920005
• DOI: 10.1136/adc.2009.182139
• Languages: English
• ISSNs: 0003-9888

Abstract

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.