Gastmans Chris, Lemiengre Joke, van der Wal Gerrit, Schotsmans Paul, Dierckx de Casterlé Bernadette
Katholieke Universiteit Leuven, Centre for Biomedical Ethics and Law, Kapucijnenvoer 35, Leuven 3000, Belgium.
Health Policy. 2006 Apr;76(2):169-78. doi: 10.1016/j.healthpol.2005.09.003. Epub 2005 Oct 10.
Euthanasia is performed worldwide, regardless of the existence of laws governing it. Belgium became the second country in the world to enact a law on euthanasia in 2002. Healthcare institutions bear responsibility for guaranteeing the quality of care for patients at the end of life, and for ensuring support for caregivers involved. Therefore, institutional ethics policies on end-of-life decision-making, especially on euthanasia, may be useful.
A cross-sectional mail survey of general directors of Catholic hospitals and nursing homes in Belgium was used to describe the prevalence and content of written ethics policies for competent terminally ill, incompetent terminally ill, and non-terminally ill patients.
Of the 298 targeted institutions, 81% of hospitals and 62% of nursing homes returned complete questionnaires. Of these, 79% of hospitals and 30% of nursing homes had a written ethics policy on euthanasia. Of hospitals 83% and of nursing homes 85% permitted euthanasia for competent terminally ill patients only in exceptional cases in accordance with legal due care criteria and provisions outlined by the palliative filter procedure. Euthanasia for incompetent terminally ill patients was prohibited by 27% of the hospitals and by 60% of the nursing homes. For non-terminally ill patients, these figures were 43 and 64%, respectively.
Catholic healthcare institutions in Belgium (Flanders) made great efforts to develop written ethics policies on euthanasia. Only a small group of institutions completely prohibited euthanasia. Most of the institutions considered euthanasia to be an option if all possible alternatives (e.g., palliative filter procedure, which contains more rigorous criteria than those in the Belgian Euthanasia Act), have been thoroughly investigated.
无论是否存在相关法律，安乐死在全球范围内都有实施。比利时于2002年成为世界上第二个颁布安乐死法律的国家。医疗机构有责任保障临终患者的护理质量，并确保为相关护理人员提供支持。因此，关于临终决策，尤其是安乐死的机构伦理政策可能会有所帮助。
对比利时天主教医院和养老院的院长进行横断面邮件调查，以描述针对有行为能力的绝症患者、无行为能力的绝症患者和非绝症患者的书面伦理政策的普及率和内容。
在298家目标机构中，81%的医院和62%的养老院返回了完整问卷。其中，79%的医院和30%的养老院有关于安乐死的书面伦理政策。83%的医院和85%的养老院仅在符合法律应尽注意标准和姑息性筛选程序规定的特殊情况下，允许为有行为能力的绝症患者实施安乐死。27%的医院和60%的养老院禁止为无行为能力的绝症患者实施安乐死。对于非绝症患者，这一比例分别为43%和64%。
比利时（弗拉芒大区）的天主教医疗机构在制定关于安乐死的书面伦理政策方面做出了巨大努力。只有一小部分机构完全禁止安乐死。大多数机构认为，如果所有可能的替代方案（如姑息性筛选程序，其标准比比利时安乐死法更为严格）都已得到彻底研究，安乐死可以作为一种选择。
