GUIDELINES ON EUTHANASIA AND PAIN ALLEVIATION - COMPLIANCE AND OPINIONS OF PHYSICIANS

The objectives of this study are to describe: (a) the presence of; and (b) compliance with guidelines in cases of euthanasia and intensifyin g the alleviation of pain and symptoms; (c) the opinions of physicians about written guidelines; and (d) the relationship between meeting th e requirements for prudent practice and presence oil and compliance wi th guidelines for euthanasia or assisted suicide (EAS). In 1990 and 19 95 interviews were held with 405 physicians (general practitioners; nu rsing home physicians and clinical specialists). The response rate for the 2 years was 91 and 89%, respectively. The percentage of physician s who reported the existence of EAS guidelines increased from 50% in 1 990 to 59% in 1995, and the compliance with these guidelines increased from 51 to 75%, respectively. Of the physicians, 17% stated that ther e were written guidelines for intensifying the alleviation of pain and symptoms. With regard to meeting the requirements for prudent practic e, we found mostly no differences between cases of euthanasia in which EAS guidelines were present, and cases in which there were no guideli nes. However, when guidelines did exist and were actually used, it see ms there was a better adherence to consultation and notification, alth ough numbers were small. The increase since 1990 in agreement with the statement that an institution should formulate a policy with regard t o euthanasia, may reflect the growing awareness of the specific role o f the management, and not only the physician, in this matter. (C) 1998 Elsevier Science Ireland Ltd. All rights reserved.