Obligatory consultation of an independent physician on euthanasia requests in the Netherlands: what influences the SCEN physicians judgment of the legal requirements of due care?

Health Policy. 2014 Mar;115(1):75-81. doi: 10.1016/j.healthpol.2013.12.002. Epub 2013 Dec 15.


Background: In the Netherlands, euthanasia is allowed if physicians adhere to legal requirements. Consultation of an independent physician is one of the requirements. SCEN (Support and Consultation on Euthanasia in the Netherlands) physicians have been trained to provide such consultations.

Objective: To study why euthanasia requests are sometimes judged not to meet requirements of due care and to find out which characteristics are associated with the SCEN physicians' judgments.

Methods: During 5 years (2006, 2008-2011) standardized registration forms were used for data-collection. We used multilevel logistic regression analysis to assess the associations of characteristics and SCEN physicians' judgments.

Results: We analyzed 1631 euthanasia requests, involving 415 SCEN physicians. Patient characteristics that were associated with a lower likelihood to meet due care requirements were: being tired with life, depression and not wanting to be a burden. Physical suffering and higher patient age were related to greater chances of meeting the requirements. There was no clear association between SCEN physicians' characteristics and their judgment.

Conclusion: Psychological suffering involves a greater chance that SCEN physicians judge that requirements of due care are not met. The association between SCEN physician characteristics and the judgment of euthanasia requests is limited, suggesting uniformity in their judgment.

Keywords: Consultation; End-of-life decision-making; Euthanasia.

MeSH terms

  • Age Factors
  • Aged
  • Cross-Sectional Studies
  • Euthanasia, Active, Voluntary / legislation & jurisprudence*
  • Euthanasia, Active, Voluntary / statistics & numerical data
  • Female
  • Humans
  • Judgment
  • Male
  • Middle Aged
  • Netherlands
  • Pain / epidemiology
  • Physicians / legislation & jurisprudence
  • Physicians / statistics & numerical data
  • Referral and Consultation / legislation & jurisprudence*
  • Referral and Consultation / statistics & numerical data
  • Surveys and Questionnaires
  • Terminal Care / legislation & jurisprudence
  • Terminal Care / statistics & numerical data