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End-of-life decision making in neonates and infants: comparison of the Netherlands and Belgium (Flanders)

(2007) ACTA PAEDIATRICA. 96(6). p.820-824
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Abstract
Aim: We compared the results of two recent studies on end-of-life decisions (ELDs) for neonates and infants in Belgium (Flanders) and the Netherlands. Methods: Questionnaires were sent to physicians who reported the death of a child under the age of 1 (Belgium: n = 292, response 87%; Netherlands: n = 249, response 84%). The questionnaires included structured questions about whether death had been preceded by ELDs, and about the decision-making process. Results: In both countries, in about 25% of all deaths a life-sustaining treatment was withheld, and in about 40% pain or other symptoms were alleviated taking into account that death might be hastened. In Belgium, a life-sustaining treatment was less often withdrawn than in the Netherlands (32% vs. 50%, respectively). Drugs were administered with the explicit intention of hastening death in similar percentages of all deaths (Belgium: 7%; Netherlands: 9%). Dutch physicians more often than Belgian physicians discussed ELDs with parents (96% vs. 81%, respectively), and with colleague physicians (94% vs. 80%, respectively). Conclusions: End-of-life decision making in severely ill neonates seems to be rather similar in Belgium and the Netherlands. Differences are that Dutch physicians more often withdraw life-sustaining treatment. Furthermore, parents and colleague physicians are more often involved in the decision making in the Netherlands.
Keywords
withdrawing treatment, hastening death, withholding treatment, SELF-REPORTED PRACTICES, INTENSIVE-CARE UNITS, EUROPEAN COUNTRIES, EUTHANASIA, SUPPORT

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Chicago
Vrakking, Astrid M, Agnes van der Heide, Veerle Provoost, Johan Bilsen, Gerrit van der Wal, and Luc Deliens. 2007. “End-of-life Decision Making in Neonates and Infants: Comparison of the Netherlands and Belgium (Flanders).” Acta Paediatrica 96 (6): 820–824.
APA
Vrakking, A. M., van der Heide, A., Provoost, V., Bilsen, J., van der Wal, G., & Deliens, L. (2007). End-of-life decision making in neonates and infants: comparison of the Netherlands and Belgium (Flanders). ACTA PAEDIATRICA, 96(6), 820–824.
Vancouver
1.
Vrakking AM, van der Heide A, Provoost V, Bilsen J, van der Wal G, Deliens L. End-of-life decision making in neonates and infants: comparison of the Netherlands and Belgium (Flanders). ACTA PAEDIATRICA. 2007;96(6):820–4.
MLA
Vrakking, Astrid M, Agnes van der Heide, Veerle Provoost, et al. “End-of-life Decision Making in Neonates and Infants: Comparison of the Netherlands and Belgium (Flanders).” ACTA PAEDIATRICA 96.6 (2007): 820–824. Print.
@article{380111,
  abstract     = {Aim: We compared the results of two recent studies on end-of-life decisions (ELDs) for neonates and infants in Belgium (Flanders) and the Netherlands. 
Methods: Questionnaires were sent to physicians who reported the death of a child under the age of 1 (Belgium: n = 292, response 87\%; Netherlands: n = 249, response 84\%). The questionnaires included structured questions about whether death had been preceded by ELDs, and about the decision-making process. 
Results: In both countries, in about 25\% of all deaths a life-sustaining treatment was withheld, and in about 40\% pain or other symptoms were alleviated taking into account that death might be hastened. In Belgium, a life-sustaining treatment was less often withdrawn than in the Netherlands (32\% vs. 50\%, respectively). Drugs were administered with the explicit intention of hastening death in similar percentages of all deaths (Belgium: 7\%; Netherlands: 9\%). Dutch physicians more often than Belgian physicians discussed ELDs with parents (96\% vs. 81\%, respectively), and with colleague physicians (94\% vs. 80\%, respectively). 
Conclusions: End-of-life decision making in severely ill neonates seems to be rather similar in Belgium and the Netherlands. Differences are that Dutch physicians more often withdraw life-sustaining treatment. Furthermore, parents and colleague physicians are more often involved in the decision making in the Netherlands.},
  author       = {Vrakking, Astrid M and van der Heide, Agnes and Provoost, Veerle and Bilsen, Johan and van der Wal, Gerrit and Deliens, Luc},
  issn         = {0803-5253},
  journal      = {ACTA PAEDIATRICA},
  language     = {eng},
  number       = {6},
  pages        = {820--824},
  title        = {End-of-life decision making in neonates and infants: comparison of the Netherlands and Belgium (Flanders)},
  url          = {http://dx.doi.org/10.1111/j.1651-2227.2007.00290.x},
  volume       = {96},
  year         = {2007},
}

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