VU University Medical Center, EMGO Institute for Health and Care Research, Van der Boechorststraat 7, Amsterdam, The Netherlands.
J Med Ethics. 2012 Jan;38(1):35-42. doi: 10.1136/jme.2010.041020. Epub 2011 Jun 27.
To describe the content of practice guidelines on euthanasia and assisted suicide (EAS) and to compare differences between settings and guidelines developed before or after enactment of the euthanasia law in 2002 by means of a content analysis. Most guidelines stated that the attending physician is responsible for the decision to grant or refuse an EAS request. Due care criteria were described in the majority of guidelines, but aspects relevant for assessing these criteria were not always described. Half of the guidelines described the role of the nurse in the performance of euthanasia. Compared with hospital guidelines, nursing home guidelines were more often stricter than the law in excluding patients with dementia (30% vs 4%) and incompetent patients (25% vs 4%). As from 2002, the guidelines were less strict in categorically excluding patients groups (32% vs 64%) and in particular incompetent patients (10% vs 29%). Healthcare institutions should accurately state the boundaries of the law, also when they prefer to set stricter boundaries for their own institution. Only then can guidelines provide adequate support for physicians and nurses in the difficult EAS decision-making process.
描述安乐死和协助自杀（EAS）实践指南的内容，并通过内容分析比较 2002 年安乐死法颁布前后制定的指南在设置和指南方面的差异。大多数指南规定主治医生负责决定是否批准 EAS 请求。大多数指南都描述了适当照顾的标准，但并非总是描述评估这些标准的相关方面。一半的指南描述了护士在实施安乐死方面的作用。与医院指南相比，养老院指南在排除痴呆症患者（30%比 4%）和无行为能力的患者（25%比 4%）方面比法律更为严格。自 2002 年以来，在明确排除患者群体（32%比 64%）和特别无行为能力的患者（10%比 29%）方面，指南的规定不再那么严格。医疗机构应准确说明法律的界限，即使他们更愿意为自己的机构设定更严格的界限。只有这样，指南才能为医生和护士在艰难的 EAS 决策过程中提供充分的支持。
