Euthanasia in advanced dementia: an empirical study of the decision-making process based on advance directives.
Background In the Netherlands, euthanasia or physician-assisted suicide are criminal offences, yet physicians may be exempt from prosecution if they meet statutory due care criteria. This exemption also applies in situations where a written advance euthanasia directive (AED) is relied upon after dec...
| Publicado en: | Age & Ageing Vol. 55; no. 6; pp. 1 - 13 |
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| Autores principales: | , , , , , , |
| Formato: | Artículo |
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Oxford University Press / USA
Jun2026
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| Materias: | |
| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ssf&AN=195099719&site=ehost-live header: @attributes: shortDbName: ssf uiTerm: 195099719 longDbName: Social Sciences Full Text (H.W. Wilson) uiTag: AN controlInfo: bkinfo: jinfo: jid: 00020729 AGA jtl: Age & Ageing issn: 00020729 maglogo: N pubinfo: dt: Jun2026 vid: 55 iid: 6 pid: 622 pub: Oxford University Press / USA artinfo: ui: 195099719 10.1093/ageing/afag170 ppf: 1 ppct: 12 formats: tig: atl: Euthanasia in advanced dementia: an empirical study of the decision-making process based on advance directives. aug: au: Coers, Djura O Ronde, Brigit Sizoo, Eefje M Hertogh, Cees M P M Smalbrugge, Martin Leget, Carlo J W Boer, Marike E de affil: Medicine for Older People, Amsterdam UMC Locatie VUmc, Amsterdam, Noord-Holland, The NetherlandsAgeing and Later Life, Amsterdam Public Health Research Institute, Amsterdam, Noord-Holland, The Netherlands Medicine for Older People, Amsterdam UMC Locatie VUmc, Amsterdam, Noord-Holland, The Netherlands Care Ethics, University for Humanistic Studies, Utrecht, Utrecht, The Netherlands su: Netherlands Euthanasia laws Legal procedure Qualitative research Empirical research Interviewing Ethical decision making Family attitudes Terminal care Advance directives (Medical care) Patients' attitudes Assisted suicide laws Professional practice Research funding Physicians' attitudes Thematic analysis Attitudes of medical personnel Research methodology Medical coding Dementia Comparative studies Data analysis software sug: subj: Euthanasia laws Legal procedure Qualitative research Empirical research Interviewing Ethical decision making Family attitudes Terminal care Advance directives (Medical care) Patients' attitudes Netherlands Offices of physicians Offices of Physicians (except Mental Health Specialists) Assisted suicide laws Professional practice Research funding Physicians' attitudes Thematic analysis Attitudes of medical personnel Research methodology Medical coding Dementia Comparative studies Data analysis software keyword: advance euthanasia directive copyrightHolder:British Geriatrics Society copyrightYear:2026 decision making decision-making decisional capacity dementia end-of-life care euthanasia https://dx.doi.org/10.1093/ageing/afag170 inLanguage:en older people publisher:Oxford University Press qualitative research sameAs:https://pubmed.ncbi.nlm.nih.gov/42328803/ advance euthanasia directive copyrightHolder:British Geriatrics Society copyrightYear:2026 decision making decision-making decisional capacity dementia end-of-life care euthanasia https://dx.doi.org/10.1093/ageing/afag170 inLanguage:en older people publisher:Oxford University Press qualitative research sameAs:https://pubmed.ncbi.nlm.nih.gov/42328803/ ab: Background In the Netherlands, euthanasia or physician-assisted suicide are criminal offences, yet physicians may be exempt from prosecution if they meet statutory due care criteria. This exemption also applies in situations where a written advance euthanasia directive (AED) is relied upon after decision-making capacity is lost. Although such cases are rare, it remains unclear how physicians, other healthcare professionals and relatives interpret and translate written wishes into ethically and legally defensible practice. Methods We conducted a qualitative case study of 14 real-life AED-based euthanasia cases—seven performed and seven forgone—using semi-structured interviews with 21 stakeholders (14 physicians, 10 other healthcare professionals, 5 relatives). Data were analysed with constant-comparison and framework analysis until saturation. Results Five interrelated considerations guided each decision-making process: weighing the AED, assessing current wishes, the elusive nature of unbearable suffering, exploring alternatives and putting plans into action. Four contextual factors shaped judgement across cases: the physician–patient relationship, record-keeping, professional experience and seeking validation from others. Conclusion Decision-making on AED-based euthanasia is layered and uncertain, requiring physicians to weigh the patient's earlier written wishes against present expressions, observable suffering and input from others; when these elements cannot be brought together, participants deem euthanasia ethically unjustifiable. pubtype: Academic Journal doctype: Article src: R language: English refInfo: copyright: @attributes: flag: N holdings: @attributes: islocal: N |
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