End-of-Life Decisions in Multidisciplinary Care Studied

Patients in Belgium who undergo spiritual care are more likely to choose euthanasia

07 aug 2009-- End-of-life decisions in Belgium often involve multidisciplinary palliative care, and patients who receive spiritual care are more likely to choose euthanasia or physician-assisted suicide, according to a study published online July 30 in BMJ.

Lieve Van den Block, Ph.D., from Vrije Universiteit Brussel in Belgium, and colleagues examined how end-of-life medical decisions affect the care provided during the final three months of life using data on 1,690 non-sudden deaths in Belgium over a two-year period.

The researchers found that patients who used specialist multidisciplinary palliative care services had more intensive alleviation of symptoms (odds ratio, 2.1), more continuous deep sedation forgoing nutrition or hydration (odds ratio, 2.9), and made more decisions explicitly designed to shorten life (odds ratio, 1.5), but not particularly euthanasia or physician-assisted suicide. However, the authors note, patients who received spiritual care were far more likely to choose euthanasia or physician-assisted suicide than those who did not receive spiritual care (odds ratio, 18.5).

"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," Van den Block and colleagues conclude.

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