August 13, 2022

Latest end-of-life statistics from the Netherlands

Nearly 1 death in 20 is due to euthanasia

More statistics about euthanasia from the Netherlands, based on the latest figures from 2015. Nearly one death in 20 (4.5%) is now due to euthanasia.

The figures come from a letter in the latest issue of the New England Journal of Medicine. “It looks like patients are now more willing to ask for euthanasia and physicians are more willing to grant it,” said lead author Dr. Agnes van der Heide of Erasmus University Medical Center in Rotterdam.

But the statistics for euthanasia alone masks the proportion of end-of-life decisions in the Netherlands. The figures for some categories overlap, but 4.5% of all deaths happened through euthanasia, 0.1% through physician-assisted suicide; and 18.3% through “continuous deep sedation”.

This last category is slippery and controversial. It accounts for nearly 1 death in 5 in the Netherlands. In some cases doctors agree that it is appropriate for refractory pain; but it can also be a form of “slow euthanasia” used to evade regulation and scrutiny.

The statistics are based on a questionnaire given to all Dutch physicians which more than three-quarters answered. “Ending of life without an explicit patient request” accounts for 0.3% of all deaths. This has decreased since 1990, when the figure was 0.8%. But possibly some doctors are using continuous deep sedation instead.

Bioethicists observed that the increase was to be expected. “Doctors become more confident in practicing euthanasia and more patients will start asking for it,” said Penney Lewis, co-director of the Centre of Medical Law and Ethics at King’s College London.

Dr van der Heide suggested that the small but increasing number of euthanasia deaths for people who were not terminally ill was troubling. “When assisted dying is becoming the more normal option at the end of life, there is a risk people will feel more inclined to ask for it,” she said.

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