Groenewoud A Stef, Westert Gert P, Boer Theo A
Scientific Center for Quality of Healthcare, Radboud University Medical Center, PO Box 9101, Nijmegen, 6500 HB, the Netherlands.
Protestant Theological University, Groningen, the Netherlands.
Res Health Serv Reg. 2023 Nov 29;2(1):19. doi: 10.1007/s43999-023-00034-6.
Considerable geographical variation in the uptake of euthanasia has been reported: some municipalities in the Netherlands have a 25 times higher euthanasia rate than other municipalities. Current 'geomedical' frameworks for interpreting practice variation in health care utilization seem inadequately tailored to understand regional variation in morally controversial procedures such as euthanasia. The aim of this conceptual article is threefold: i) to add relevant medical ethical principles to current frameworks; ii) to provide a four-step ethical-geomedical model for the interpretation of geographical differences in the utilization of health care in general and for ethically controversial treatments in specific; iii) to gain better understanding of the existing geographical variation in the incidence of euthanasia by using this framework in our analysis.
据报道，安乐死的接受情况存在显著的地域差异：荷兰的一些市镇安乐死率比其他市镇高出25倍。当前用于解释医疗保健利用实践差异的“地理医学”框架，似乎并不足以理解诸如安乐死等道德上有争议的程序的地区差异。这篇概念性文章的目的有三个：其一，在当前框架中加入相关医学伦理原则；其二，提供一个四步伦理地理医学模型，用于解释一般医疗保健利用中的地域差异，特别是针对有伦理争议的治疗方法；其三，通过在分析中使用这个框架，更好地理解安乐死发生率现有的地域差异。
