Advanced search
1 file | 97.35 KB

Medical end-of-life decisions in children in Flanders, Belgium

Geert Pousset (UGent) , Johan Bilsen (UGent) , Joachim Cohen (UGent) , Kenneth Chambaere (UGent) , Luc Deliens (UGent) and Freddy Mortier (UGent)
Author
Organization
Abstract
Objectives: To estimate the prevalence of end-of-life decisions and to describe their characteristics and the preceding decision-making process in minors in Belgium. Design: Population-based postmortem anonymous physician survey. Setting: Flanders, Belgium. Participants: All physicians signing the death certificates of all patients (N=250) aged 1 to 17 years who died between June 2007 and November 2008 in Flanders, Belgium. Outcome Measures: Prevalence and characteristics of end-of-life decisions and the preceding decisionmaking process. Results: For 165 of the 250 deaths, a physician questionnaire was returned (70.5%). In 36.4%, death was preceded by an end-of-life decision. Drugs were administered to alleviate pain and symptoms with a possible life-shortening effect in 18.2% of all deaths, nontreatment decisions were made in 10.3%, and lethal drugs without the patient’s explicit request were used in 7.9%. No cases of euthanasia, ie, the use of drugs with the explicit intention to hasten death at the patient’s explicit request, were reported. Poor clinical prospects (84.6%) and low quality of life expectations (61.5%) were important reasons for the physicians to engage in end-of-life decisions. Parents were involved in decision making in 85.2% of these decisions, patients in 15.4%. Conclusions: Medical end-of-life decisions are frequent in minors in Flanders, Belgium. Whereas parents were involved in most end-of-life decisions, the patients themselves were involved much less frequently, even when the ending of their lives was intended. At the time of decision making, patients were often comatose or the physicians deemed them incompetent or too young to be involved.
Keywords
PHYSICIAN-ASSISTED SUICIDE, NETHERLANDS, INTENSIVE-CARE UNITS, DEATH, PROTOCOL, INFANTS, COUNTRIES, EUTHANASIA LAW

Downloads

  • (...).pdf
    • full text
    • |
    • UGent only
    • |
    • PDF
    • |
    • 97.35 KB

Citation

Please use this url to cite or link to this publication:

Chicago
Pousset, Geert, Johan Bilsen, Joachim Cohen, Kenneth Chambaere, Luc Deliens, and Freddy Mortier. 2010. “Medical End-of-life Decisions in Children in Flanders, Belgium.” Archives of Pediatrics & Adolescent Medicine 164 (6): 547–553.
APA
Pousset, G., Bilsen, J., Cohen, J., Chambaere, K., Deliens, L., & Mortier, F. (2010). Medical end-of-life decisions in children in Flanders, Belgium. ARCHIVES OF PEDIATRICS & ADOLESCENT MEDICINE, 164(6), 547–553.
Vancouver
1.
Pousset G, Bilsen J, Cohen J, Chambaere K, Deliens L, Mortier F. Medical end-of-life decisions in children in Flanders, Belgium. ARCHIVES OF PEDIATRICS & ADOLESCENT MEDICINE. 2010;164(6):547–53.
MLA
Pousset, Geert, Johan Bilsen, Joachim Cohen, et al. “Medical End-of-life Decisions in Children in Flanders, Belgium.” ARCHIVES OF PEDIATRICS & ADOLESCENT MEDICINE 164.6 (2010): 547–553. Print.
@article{1001015,
  abstract     = {Objectives: To estimate the prevalence of end-of-life decisions and to describe their characteristics and the preceding decision-making process in minors in Belgium.
Design: Population-based postmortem anonymous physician survey.
Setting: Flanders, Belgium.
Participants: All physicians signing the death certificates of all patients (N=250) aged 1 to 17 years who died between June 2007 and November 2008 in Flanders, Belgium.
Outcome Measures: Prevalence and characteristics of end-of-life decisions and the preceding decisionmaking process.
Results: For 165 of the 250 deaths, a physician questionnaire was returned (70.5\%). In 36.4\%, death was
preceded by an end-of-life decision. Drugs were administered to alleviate pain and symptoms with a possible life-shortening effect in 18.2\% of all deaths, nontreatment decisions were made in 10.3\%, and lethal drugs without the patient{\textquoteright}s explicit request were used in 7.9\%. No cases of euthanasia, ie, the use of drugs with the explicit intention to hasten death at the patient{\textquoteright}s explicit request, were reported. Poor clinical prospects (84.6\%) and low quality of life expectations (61.5\%) were important reasons for the physicians to engage in end-of-life decisions. Parents were involved in decision making in 85.2\% of these decisions, patients in 15.4\%.
Conclusions: Medical end-of-life decisions are frequent in minors in Flanders, Belgium. Whereas parents
were involved in most end-of-life decisions, the patients themselves were involved much less frequently, even when the ending of their lives was intended. At the time of decision making, patients were often comatose or the physicians deemed them incompetent or too young to be involved.},
  author       = {Pousset, Geert and Bilsen, Johan and Cohen, Joachim and Chambaere, Kenneth and Deliens, Luc and Mortier, Freddy},
  issn         = {1072-4710},
  journal      = {ARCHIVES OF PEDIATRICS \& ADOLESCENT MEDICINE},
  keyword      = {PHYSICIAN-ASSISTED SUICIDE,NETHERLANDS,INTENSIVE-CARE UNITS,DEATH,PROTOCOL,INFANTS,COUNTRIES,EUTHANASIA LAW},
  language     = {eng},
  number       = {6},
  pages        = {547--553},
  title        = {Medical end-of-life decisions in children in Flanders, Belgium},
  volume       = {164},
  year         = {2010},
}

Web of Science
Times cited: