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Attitudes and practices of physicians regarding physician-assisted dying in minors

Geert Pousset (UGent) , Freddy Mortier (UGent) , Johan Bilsen (UGent) , Joachim Cohen (UGent) and Luc Deliens (UGent)
(2011) ARCHIVES OF DISEASE IN CHILDHOOD. 96(10). p.948-953
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Organization
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.
Keywords
OF-LIFE DECISIONS, UNIT, FLANDERS, BELGIUM, COUNTRIES, SUICIDE, NETHERLANDS, PEDIATRIC INTENSIVE-CARE, END, EUTHANASIA LAW

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Citation

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

Chicago
Pousset, Geert, Freddy Mortier, Johan Bilsen, Joachim Cohen, and Luc Deliens. 2011. “Attitudes and Practices of Physicians Regarding Physician-assisted Dying in Minors.” Archives of Disease in Childhood 96 (10): 948–953.
APA
Pousset, G., Mortier, F., Bilsen, J., Cohen, J., & Deliens, L. (2011). Attitudes and practices of physicians regarding physician-assisted dying in minors. ARCHIVES OF DISEASE IN CHILDHOOD, 96(10), 948–953.
Vancouver
1.
Pousset G, Mortier F, Bilsen J, Cohen J, Deliens L. Attitudes and practices of physicians regarding physician-assisted dying in minors. ARCHIVES OF DISEASE IN CHILDHOOD. 2011;96(10):948–53.
MLA
Pousset, Geert, Freddy Mortier, Johan Bilsen, et al. “Attitudes and Practices of Physicians Regarding Physician-assisted Dying in Minors.” ARCHIVES OF DISEASE IN CHILDHOOD 96.10 (2011): 948–953. Print.
@article{1001172,
  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.},
  author       = {Pousset, Geert and Mortier, Freddy and Bilsen, Johan and Cohen, Joachim and Deliens, Luc},
  issn         = {0003-9888},
  journal      = {ARCHIVES OF DISEASE IN CHILDHOOD},
  keyword      = {OF-LIFE DECISIONS,UNIT,FLANDERS,BELGIUM,COUNTRIES,SUICIDE,NETHERLANDS,PEDIATRIC INTENSIVE-CARE,END,EUTHANASIA LAW},
  language     = {eng},
  number       = {10},
  pages        = {948--953},
  title        = {Attitudes and practices of physicians regarding physician-assisted dying in minors},
  url          = {http://dx.doi.org/10.1136/adc.2009.171918},
  volume       = {96},
  year         = {2011},
}

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