Het gebruik van middelen bij euthanasie en hulp bij zelfdoding in de huisartspraktijk

– An exploratory, descriptive, retrospective study was carried out concerning the use of means for euthanasia or assisted suicide, primarily regarding the period 1986-1989. Data were collected via an anonymous written inquiry among a random sample of family physicians in North Holland (n = 521) and family physicians in the rest of the Netherlands (n = 521). The inquiry contained among others questions about the last case they had encountered. In addition, police reports of euthanasia or assisted suicide administered by family physicians in North Holland (n = 263) were analysed.

The response to the inquiry was 67; (non-respondents did not differ from respondents): 388 cases could be analysed. The use of euthanatics by family physicians in North Holland and those in the rest of the Netherlands was identical. More than 40 different euthanatics were used, most of them incidentally. The most frequently used (combination of) means were a benzodiazepine with a neuromuscular relaxant (23), a barbiturate with a neuromuscular relaxant (20), barbiturates (15) and opioides (12). Most euthanatics were given intravenously (61, of which 5 by infusion), orally 21, intramuscularly 12, rectally 3 and subcutaneously 2. The quantities applied varied greatly. The average length of time from the start of the procedure till decease was 3.8 hours (≤ 1 minute-72 hours). In 12 of the cases complications or unintended effects were reported. Comparison of inquiry and police reports showed some differences.

It appears that many family physicians act according to the guidelines of Admiraal and – to a lesser extent – those of the Royal Netherlands Association of Pharmacy, either by direct consultation or indirectly via consultation with pharmacist or colleague. A substantial group of family physicians handle euthanatics inadequately. A further investigation and exchange of experiences about the use of euthanatics, the ‘ideal’ time interval before death et cetera, is desirable.