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三个国家的合法安乐死和医师协助自杀的异同:基于人口水平的比较。

Commonalities and differences in legal euthanasia and physician-assisted suicide in three countries: a population-level comparison.

机构信息

End-of-Life Care Research Group, Vrije Universiteit Brussel (VUB), Brussels, Belgium.

End-of-Life Care Research Group, Ghent University, Ghent, Belgium.

出版信息

Int J Public Health. 2020 Jan;65(1):65-73. doi: 10.1007/s00038-019-01281-6. Epub 2019 Jul 11.

Abstract

OBJECTIVES

To describe and compare euthanasia and physician-assisted suicide (EAS) practice in Flanders, Belgium (BE), the Netherlands (NL) and Switzerland (CH).

METHODS

Mortality follow-back surveys among attending physicians of a random sample of death certificates.

RESULTS

We studied 349 EAS deaths in BE (4.6% of all deaths), 851 in NL (4.6% of all deaths) and 65 in CH (1.4% of all deaths). People who died by EAS were mostly aged 65 or older (BE: 81%, NL: 77% and CH: 71%) and were mostly diagnosed with cancer (BE: 57% and NL: 66%). Home was the most common place of death in NL (79%), while in BE and CH, more variation was found regarding to place of death. The decision to perform EAS was more frequently discussed with a colleague physician in BE (93%) and NL (90%) than in CH (60%).

CONCLUSIONS

EAS practice characteristics vary considerably in the studied countries with legal EAS. In addition to the legal context, cultural factors as well as the manner in which legislation is implemented play a role in how EAS legislation translates into practice.

摘要

目的

描述并比较比利时佛兰德斯(BE)、荷兰(NL)和瑞士(CH)的安乐死和医师协助自杀(EAS)实践。

方法

对死亡证明中随机样本的主治医生进行死亡后随访调查。

结果

我们研究了 BE 中的 349 例 EAS 死亡案例(占所有死亡人数的 4.6%)、NL 中的 851 例(占所有死亡人数的 4.6%)和 CH 中的 65 例(占所有死亡人数的 1.4%)。实施 EAS 而死亡的人大多年龄在 65 岁及以上(BE:81%,NL:77%和 CH:71%),且大多被诊断患有癌症(BE:57%和 NL:66%)。NL 是最常见的死亡地点(79%),而 BE 和 CH 则存在更多的死亡地点差异。在 BE(93%)和 NL(90%)中,与同事医生讨论 EAS 决策的频率明显高于 CH(60%)。

结论

在安乐死合法的研究国家中,EAS 实践特征存在显著差异。除了法律背景外,文化因素以及立法实施方式也在安乐死立法如何转化为实践方面发挥作用。

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