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老年累积健康问题患者的安乐死与医生协助自杀:荷兰医生的一项横断面问卷调查研究

Euthanasia and Physician-Assisted Suicide in People With an Accumulation of Health Problems Related to Old Age: A Cross-Sectional Questionnaire Study Among Physicians in the Netherlands.

作者信息

Kraak-Steenken Frédérique W M, Renckens Sophie C, Pasman H Roeline W, Bosma Fenne, van der Heide Agnes, Onwuteaka-Philipsen Bregje D

机构信息

Department of Public and Occupational Health, Amsterdam Public Health Research Institute, VU Medical Center, Amsterdam, Netherlands.

Expertise Center for Palliative Care Amsterdam UMC, Amsterdam, Netherlands.

出版信息

Int J Public Health. 2024 Apr 18;69:1606962. doi: 10.3389/ijph.2024.1606962. eCollection 2024.

Abstract

We explored characteristics of people with an accumulation of health problems related to old age requesting euthanasia or physician-assisted suicide (EAS) and identified characteristics associated with granting EAS requests. We conducted a cross-sectional questionnaire study among Dutch physicians on characteristics of these people requesting EAS ( = 123). Associations between characteristics and granting a request were assessed using logistic regression analyses. People requesting EAS were predominantly >80 years old (82.4%), female (70.0%), widow/widower (71.7%), (partially) care-dependent (76.7%), and had a life expectancy >12 months (68.6%). The most prevalent health problems were osteoarthritis (70.4%) and impaired vision and hearing (53.0% and 40.9%). The most cited reasons to request EAS were physical deterioration (68.6%) and dependence (61.2%). 44.7% of requests were granted. Granting a request was positively associated with care dependence, disability/immobility, impaired vision, osteoporosis, loss of control, suffering without prospect of improvement and a treatment relationship with the physician >12 months. Enhanced understanding of people with an accumulation of health problems related to old age requesting EAS can contribute to the ongoing debate on the permissibility of EAS in people without life-threatening conditions.

摘要

我们探究了有与老年相关的多种健康问题且请求安乐死或医生协助自杀(EAS)者的特征,并确定了与批准EAS请求相关的特征。我们针对这些请求EAS者的特征(n = 123),对荷兰医生开展了一项横断面问卷调查研究。使用逻辑回归分析评估特征与批准请求之间的关联。请求EAS者大多年龄超过80岁(82.4%),女性(70.0%),丧偶(71.7%),(部分)依赖照护(76.7%),预期寿命超过12个月(68.6%)。最常见的健康问题是骨关节炎(70.4%)以及视力和听力受损(分别为53.0%和40.9%)。请求EAS最常提及的理由是身体机能衰退(68.6%)和依赖他人(61.2%)。44.7%的请求获得批准。批准请求与照护依赖、残疾/行动不便、视力受损、骨质疏松症、失去控制、痛苦且无改善希望以及与医生的治疗关系超过12个月呈正相关。加深对有与老年相关的多种健康问题且请求EAS者的了解,有助于正在进行的关于在无危及生命状况者中实施EAS是否可行的辩论。

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