Lemiengre Joke, Dierckx de Casterlé Bernadette, Verbeke Geert, Guisson Catherine, Schotsmans Paul, Gastmans Chris
Centre for Biomedical Ethics and Law, Katholieke Universiteit Leuven, Kapucijnenvoer 35, B-3000 Leuven, Belgium.
Health Policy. 2007 Dec;84(2-3):170-80. doi: 10.1016/j.healthpol.2007.05.007. Epub 2007 Jul 6.
To determine the prevalence, development, stance, and communication of written institutional ethics policies on euthanasia in Flemish hospitals.
Cross-sectional mail survey of general directors of all hospitals (n=81) in Flanders, Belgium.
Of the 81 hospitals invited to participate, 71 (88%) completed the questionnaire. Of these, 45 (63%) had a written ethics policy on euthanasia. The Belgian Act on Euthanasia and centrally developed guidelines of professional organisations were the most frequently mentioned reasons for and sources used in developing ethics policies on euthanasia in hospitals. Up to one-third of hospitals reported that they developed the policy upon request from physicians or nurses, or after being confronted with a euthanasia request. Development and approval of institutional ethics policies occurred within a multidisciplinary context involving clinicians, ethicists, and hospital administrators. The majority of hospitals restrictively applied the euthanasia law by introducing palliative procedures in addition to legal due care criteria. Private Catholic hospitals, in particular, were more likely to be restrictive: euthanasia is not permitted or is permitted only in exceptional cases (in accordance with legal due care criteria and additional palliative care procedures). The majority of hospitals took the initiative to communicate the policy to hospital physicians and nurses.
Since the enactment of the Belgian Act on Euthanasia in 2002, the debate on how to deal with euthanasia requests has intensified in Flemish hospitals. The high prevalence of written institutional ethics policies on euthanasia and other medical end-of-life decisions is one possible outcome of this debate.
确定弗拉芒地区医院关于安乐死的书面机构伦理政策的普及程度、制定情况、立场及沟通情况。
对比利时弗拉芒地区所有医院（n = 81）的院长进行横断面邮件调查。
在受邀参与的81家医院中，71家（88%）完成了问卷。其中，45家（63%）有关于安乐死的书面伦理政策。比利时《安乐死法案》以及专业组织集中制定的指南是医院制定安乐死伦理政策时最常提及的原因和依据。高达三分之一的医院报告称，他们是应医生或护士的要求，或在面对安乐死请求后制定该政策的。机构伦理政策的制定和批准是在临床医生、伦理学家和医院管理人员参与的多学科背景下进行的。大多数医院除了遵循法定的适当照护标准外，还通过引入姑息治疗程序来严格适用安乐死法律。尤其是私立天主教医院更倾向于严格限制：不允许安乐死，或仅在特殊情况下（符合法定适当照护标准及额外的姑息治疗程序）允许安乐死。大多数医院主动将该政策传达给医院的医生和护士。
自2002年比利时《安乐死法案》颁布以来，弗拉芒地区医院关于如何处理安乐死请求的辩论愈演愈烈。关于安乐死及其他医疗临终决策的书面机构伦理政策的高普及率是这场辩论的一个可能结果。
