Consultants in cases of intended euthanasia or assisted suicide in the Netherlands

Objective: To investigate how often physicians act as a consultant in the r eview of intended euthanasia and assisted suicide (EAS), by whom physicians are asked to act as a consultant, and the consultant's reasons for not agr eeing with the intended performance of EAS. Design: A retrospective descriptive study. Setting: The Netherlands. Participants: A stratified random sample of 405 Dutch physicians. Main outcome measures: Number of times the physician has been a consultant; how often a physician had previously been asked to be a consultant by the same treating physician; why consultants advised against EAS. Results: 42% of interviewed physicians had acted as a consultant for EAS an d 11% had been a consultant more than three times. Half the physicians who acted as a consultant more than once were invited to do so by the same atte nding physician, and 41% of consultants had previously consulted the attend ing physician. The main reasons consultants advised against EAS were becaus e treatment options were still available, the patient's request was not wel l-considered or persistent, and the patient's suffering was not unbearable and hopeless. Conclusions: Many physicians have at some time been a consultant in a case of intended EAS, but only very few have been able to gain experience in con sultancy. To guarantee high standards of consultation, it may be advisable to appoint and train specific consultants for EAS.