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Assisted dying request assessments by trained consultants : changes in practice and quality : repeated cross-sectional surveys (2008–2019)

Stijn Vissers (UGent) , Sigrid Dierickx (UGent) , Kenneth Chambaere (UGent) , Luc Deliens (UGent) , Freddy Mortier (UGent) and Joachim Cohen (UGent)
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Abstract
Objectives To study changes in the peer consultation practice of assessing assisted dying requests and its quality among trained 'Life End Information Forum' (LEIF) consultants in Belgium between 2008 and 2019. Methods Cross-sectional surveys conducted in 2008 (N=132) and 2019 (N=527) among all registered LEIF consultants. Results The response rate was 75% in 2008 and 57% in 2019. In 2019 compared with 2008, more LEIF consultants were significantly less than 40 years old (25%/10%, p=0.006) and at least 60 years old (34%/20%, p=0.006). In their activities regarding assessments of assisted dying requests over 12 months, we found a significant increase in the number of patients who did not meet the substantive requirements for assisted dying in 2019 compared with 2008 (1-4 patients: 41.1 %/58.8%, p=0.020). In their most recent assessments of an assisted dying request, LEIF consultants in 2019 made significantly more assessments of patients aged 80 years or older than in 2008 (31%/9%, p<0.001), and significantly fewer assessments for patients with cancer (53%/70%, p=0.034). Regarding adherence to quality criteria for consultation, LEIF consultants discussed unbearable suffering (87%/65%, p=0.003) and alternative treatments (palliative: 48 %/13%, p<0.001; curative: 28%/5%, p=0.002) significantly more often with the attending physician. Conclusions Changes in peer consultation practice and its quality among LEIF consultants likely reflect changes in assisted dying practice in general, as well as changes in LEIF consultations on more complex cases for which LEIF consultants' expertise is required.
Keywords
Terminal care, Service evaluation, End of life care, Ethics, Education and training, Clinical decisions, MEDICAL ASSISTANCE, PROJECT SUPPORT, EUTHANASIA, NETHERLANDS, PHYSICIANS, BELGIUM, IMPLEMENTATION, SUICIDE, TRENDS, IMPACT

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MLA
Vissers, Stijn, et al. “Assisted Dying Request Assessments by Trained Consultants : Changes in Practice and Quality : Repeated Cross-Sectional Surveys (2008–2019).” BMJ SUPPORTIVE & PALLIATIVE CARE, 2022, doi:10.1136/ bmjspcare-2021-003502.
APA
Vissers, S., Dierickx, S., Chambaere, K., Deliens, L., Mortier, F., & Cohen, J. (2022). Assisted dying request assessments by trained consultants : changes in practice and quality : repeated cross-sectional surveys (2008–2019). BMJ SUPPORTIVE & PALLIATIVE CARE. https://doi.org/10.1136/ bmjspcare-2021-003502
Chicago author-date
Vissers, Stijn, Sigrid Dierickx, Kenneth Chambaere, Luc Deliens, Freddy Mortier, and Joachim Cohen. 2022. “Assisted Dying Request Assessments by Trained Consultants : Changes in Practice and Quality : Repeated Cross-Sectional Surveys (2008–2019).” BMJ SUPPORTIVE & PALLIATIVE CARE. https://doi.org/10.1136/ bmjspcare-2021-003502.
Chicago author-date (all authors)
Vissers, Stijn, Sigrid Dierickx, Kenneth Chambaere, Luc Deliens, Freddy Mortier, and Joachim Cohen. 2022. “Assisted Dying Request Assessments by Trained Consultants : Changes in Practice and Quality : Repeated Cross-Sectional Surveys (2008–2019).” BMJ SUPPORTIVE & PALLIATIVE CARE. doi:10.1136/ bmjspcare-2021-003502.
Vancouver
1.
Vissers S, Dierickx S, Chambaere K, Deliens L, Mortier F, Cohen J. Assisted dying request assessments by trained consultants : changes in practice and quality : repeated cross-sectional surveys (2008–2019). BMJ SUPPORTIVE & PALLIATIVE CARE. 2022;
IEEE
[1]
S. Vissers, S. Dierickx, K. Chambaere, L. Deliens, F. Mortier, and J. Cohen, “Assisted dying request assessments by trained consultants : changes in practice and quality : repeated cross-sectional surveys (2008–2019),” BMJ SUPPORTIVE & PALLIATIVE CARE, 2022.
@article{8760978,
  abstract     = {{Objectives To study changes in the peer consultation practice of assessing assisted dying requests and its quality among trained 'Life End Information Forum' (LEIF) consultants in Belgium between 2008 and 2019. Methods Cross-sectional surveys conducted in 2008 (N=132) and 2019 (N=527) among all registered LEIF consultants. Results The response rate was 75% in 2008 and 57% in 2019. In 2019 compared with 2008, more LEIF consultants were significantly less than 40 years old (25%/10%, p=0.006) and at least 60 years old (34%/20%, p=0.006). In their activities regarding assessments of assisted dying requests over 12 months, we found a significant increase in the number of patients who did not meet the substantive requirements for assisted dying in 2019 compared with 2008 (1-4 patients: 41.1 %/58.8%, p=0.020). In their most recent assessments of an assisted dying request, LEIF consultants in 2019 made significantly more assessments of patients aged 80 years or older than in 2008 (31%/9%, p<0.001), and significantly fewer assessments for patients with cancer (53%/70%, p=0.034). Regarding adherence to quality criteria for consultation, LEIF consultants discussed unbearable suffering (87%/65%, p=0.003) and alternative treatments (palliative: 48 %/13%, p<0.001; curative: 28%/5%, p=0.002) significantly more often with the attending physician. Conclusions Changes in peer consultation practice and its quality among LEIF consultants likely reflect changes in assisted dying practice in general, as well as changes in LEIF consultations on more complex cases for which LEIF consultants' expertise is required.}},
  author       = {{Vissers, Stijn and Dierickx, Sigrid and Chambaere, Kenneth and Deliens, Luc and Mortier, Freddy and Cohen, Joachim}},
  issn         = {{2045-435X}},
  journal      = {{BMJ SUPPORTIVE & PALLIATIVE CARE}},
  keywords     = {{Terminal care,Service evaluation,End of life care,Ethics,Education and training,Clinical decisions,MEDICAL ASSISTANCE,PROJECT SUPPORT,EUTHANASIA,NETHERLANDS,PHYSICIANS,BELGIUM,IMPLEMENTATION,SUICIDE,TRENDS,IMPACT}},
  language     = {{eng}},
  title        = {{Assisted dying request assessments by trained consultants : changes in practice and quality : repeated cross-sectional surveys (2008–2019)}},
  url          = {{http://dx.doi.org/10.1136/ bmjspcare-2021-003502}},
  year         = {{2022}},
}

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