End-of-life decisions in medicine : emperical studies on practice and attitudes in the Netherlands

The role of psychiatrists in end-of-life decision-making will be described in Chapters 2 to 4 (part II). Chapter 2 deals with the experience of Dutch psychiatrists with requests for euthanasia or physician-assisted suicide made by patients under their treatment. Chapter 3 examines psychiatric consultation with regard to patients' requests for euthanasia or assisted suicide in more detail. The frequency with which psychiatrists are asked for consultation with regard to a patient's request for euthanasia or physician-assisted suicide is explored, as well as the content and implications of such consultation. In Chapter 4, the attitudes of Dutch psychiatrists towards physician-assisted death in psychiatric patients are further explored, and related to their specific characteristics. The use of potentially life-shortening drugs at the end of life is dealt with in Chapters 5 to 8 (part III), In Chapter 5, an overview of the knowledge of potentially life-shortening drugs is given in a review study. Chapter 6 presents an overview of all potentially life-shortening drugs that are used in the broad range of end-of-life decisions in medicine. Chapter 7 describes the use of opioids, which are important drugs in the discussion about the border zones of end-of-life decision-making. Chapter 8 focuses on the drugs that were given with the explicit intention to hasten death in cases of euthanasia and physician-assisted suicide. Not only the types of drugs are described, but also the method of administration and the complications that occur. The frequency and characteristics of decisions to withhold or withdraw lifeprolonging treatment are described in Chapter 9 (part IV), Finally, in Chapter 10 the most important findings and conclusions are summarised and discussed. This chapter concludes with some recommendations for future research.

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