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Euthanasia and other end of life decisions and care provided in final three months of life: nationwide retrospective study in Belgium

Objective To explore the relation between the care provided in the final three months of life and the prevalence and types of end of life decisions in Belgium. Design Two year nationwide retrospective study, 2005-6 (SENTI-MELC study). Setting Data collection via the sentinel network of general pract...

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Autores principales: Van den Block, Lieve, Deschepper, Reginald, Bilsen, Johan, Bossuyt, Nathalie, Van Casteren, Viviane, Deliens, Luc
Formato: Texto
Lenguaje:English
Publicado: BMJ Publishing Group Ltd. 2009
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2719064/
https://www.ncbi.nlm.nih.gov/pubmed/19643825
http://dx.doi.org/10.1136/bmj.b2772
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author Van den Block, Lieve
Deschepper, Reginald
Bilsen, Johan
Bossuyt, Nathalie
Van Casteren, Viviane
Deliens, Luc
author_facet Van den Block, Lieve
Deschepper, Reginald
Bilsen, Johan
Bossuyt, Nathalie
Van Casteren, Viviane
Deliens, Luc
author_sort Van den Block, Lieve
collection PubMed
description Objective To explore the relation between the care provided in the final three months of life and the prevalence and types of end of life decisions in Belgium. Design Two year nationwide retrospective study, 2005-6 (SENTI-MELC study). Setting Data collection via the sentinel network of general practitioners, an epidemiological surveillance system representative of all general practitioners in Belgium. Subjects 1690 non-sudden deaths in practices of the sentinel general practitioners. Main outcome measures Non-sudden deaths of patients (aged >1 year) reported each week. Reported care provided in the final three months of life and the end of life decisions made. Multivariable regression analysis controlled for age, sex, cause, and place of death. Results Use of specialist multidisciplinary palliative care services was associated with intensified alleviation of symptoms (odds ratio 2.1, 95% confidence interval 1.6 to 2.6), continuous deep sedation forgoing food/fluid (2.9, 1.7 to 4.9), and the total of decisions explicitly intended to shorten life (1.5, 1.1 to 2.1) but not with euthanasia or physician assisted suicide in particular. To a large extent receiving spiritual care was associated with higher frequencies of euthanasia or physician assisted suicide than receiving little spiritual care (18.5, 2.0 to 172.7). Conclusions End of life decisions that shorten life, including euthanasia or physician assisted suicide, are not related to a lower use of palliative care in Belgium and often occur within the context of multidisciplinary care.
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spelling pubmed-27190642009-07-31 Euthanasia and other end of life decisions and care provided in final three months of life: nationwide retrospective study in Belgium Van den Block, Lieve Deschepper, Reginald Bilsen, Johan Bossuyt, Nathalie Van Casteren, Viviane Deliens, Luc BMJ Research Objective To explore the relation between the care provided in the final three months of life and the prevalence and types of end of life decisions in Belgium. Design Two year nationwide retrospective study, 2005-6 (SENTI-MELC study). Setting Data collection via the sentinel network of general practitioners, an epidemiological surveillance system representative of all general practitioners in Belgium. Subjects 1690 non-sudden deaths in practices of the sentinel general practitioners. Main outcome measures Non-sudden deaths of patients (aged >1 year) reported each week. Reported care provided in the final three months of life and the end of life decisions made. Multivariable regression analysis controlled for age, sex, cause, and place of death. Results Use of specialist multidisciplinary palliative care services was associated with intensified alleviation of symptoms (odds ratio 2.1, 95% confidence interval 1.6 to 2.6), continuous deep sedation forgoing food/fluid (2.9, 1.7 to 4.9), and the total of decisions explicitly intended to shorten life (1.5, 1.1 to 2.1) but not with euthanasia or physician assisted suicide in particular. To a large extent receiving spiritual care was associated with higher frequencies of euthanasia or physician assisted suicide than receiving little spiritual care (18.5, 2.0 to 172.7). Conclusions End of life decisions that shorten life, including euthanasia or physician assisted suicide, are not related to a lower use of palliative care in Belgium and often occur within the context of multidisciplinary care. BMJ Publishing Group Ltd. 2009-07-30 /pmc/articles/PMC2719064/ /pubmed/19643825 http://dx.doi.org/10.1136/bmj.b2772 Text en © Block et al 2009 http://creativecommons.org/licenses/by-nc/2.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution Non-commercial License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Research
Van den Block, Lieve
Deschepper, Reginald
Bilsen, Johan
Bossuyt, Nathalie
Van Casteren, Viviane
Deliens, Luc
Euthanasia and other end of life decisions and care provided in final three months of life: nationwide retrospective study in Belgium
title Euthanasia and other end of life decisions and care provided in final three months of life: nationwide retrospective study in Belgium
title_full Euthanasia and other end of life decisions and care provided in final three months of life: nationwide retrospective study in Belgium
title_fullStr Euthanasia and other end of life decisions and care provided in final three months of life: nationwide retrospective study in Belgium
title_full_unstemmed Euthanasia and other end of life decisions and care provided in final three months of life: nationwide retrospective study in Belgium
title_short Euthanasia and other end of life decisions and care provided in final three months of life: nationwide retrospective study in Belgium
title_sort euthanasia and other end of life decisions and care provided in final three months of life: nationwide retrospective study in belgium
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2719064/
https://www.ncbi.nlm.nih.gov/pubmed/19643825
http://dx.doi.org/10.1136/bmj.b2772
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