Table 3.
Characteristics of due care for reported and unreported cases of euthanasia*
| All cases (n=137)‡ | Cases reported to review committee (n=72) | Unreported cases (n=64) | P value | ||||
|---|---|---|---|---|---|---|---|
| Weighted n | Weighted percentage of cases (95% CI) | Weighted n | Weighted percentage of cases (95% CI) | Weighted n | Weighted percentage of cases (95% CI) | ||
| Type of request for euthanasia | |||||||
| Verbal request only | 68 | 50.0 (40.1 to 60.5) | 13 | 17.6 (9.1 to 31.5) | 55 | 87.7 (76.6 to 93.9) | <0.001† |
| Written request only | 9 | 6.6 (2.3 to 18.0) | 7 | 9.3 (2.4 to 29.9) | 2 | 3.7 (0.9 to 14.5) | |
| Verbal and written request | 58 | 43.3 (33.5 to 53.1) | 53 | 73.1 (56.8 to 84.9) | 5 | 8.6 (3.9 to 18.0) | |
| Decision discussed with others‡ | |||||||
| Total | 126 | 93.3 (80.2 to 97.8) | 72 | 100 (100 to 100) | 54 | 85.2 (63.0 to 95.1) | 0.001† |
| Other physician | 106 | 77.0 (66.2 to 85.7) | 71 | 97.5 (88.1 to 99.5) | 35 | 54.6 (38.7 to 69.6) | <0.001† |
| Care giver specialised in palliative care | 67 | 49.1 (39.2 to 59.6) | 46 | 63.9 (49.6 to 76.2) | 21 | 33.0 ( 21.3 to 47.2) | <0.001† |
| Nursing staff | 72 | 53.5 (42.8 to 63.3) | 39 | 54.3 (40.5 to 67.5) | 33 | 51.9 (36.6 to 66.9) | 0.864 |
| Relative | 106 | 77.5 (66.0 to 85.8) | 57 | 78.4 (63.6 to 88.4) | 49 | 76.2 ( 57.4 to 88.4) | 0.841 |
| Other persons | 8 | 5.9 (2.9 to 11.9) | 7 | 9.1 (4.2 to 18.7) | 1 | 2.3 (0.3 to 15.0) | 0.068 |
| Drug used for euthanasia | |||||||
| Neuromuscular relaxant§ | 15 | 11.2 (6.5 to 18.9) | 15 | 22.1 (12.8 to 35.0) | 0 | — | <0.001† |
| Barbiturate¶ | 21 | 15.7 (10.5 to 23.2) | 18 | 26.5 (16.6 to 38.5) | 3 | 4.8 (1.8 to 13.0) | |
| Neuromuscular relaxant and barbiturate** | 34 | 26.6 (17.7 to 36.8) | 32 | 47.1 (34.0 to 61.9) | 2 | 3.2 (1.0 to 10.3) | |
| Opioids†† | 60 | 45.5 (35.5 to 56.4) | 3 | 4.4 (1.0 to 15.4) | 57 | 90.5 (80.2 to 94.8) | |
| Other drug | 1 | 1.0 (0.2 to 4.1) | 0 | — | 1 | 1.6 (0.5 to 8.3) | |
| Person who administered the drug | |||||||
| Physician | 96 | 72.2 (60.8 to 81.0) | 69 | 97.9 (86.5 to 99.7) | 27 | 43.0 (29.0 to 58.3) | <0.001† |
| Nurse | 26 | 19.3 (11.7 to 30.4) | 0 | — | 26 | 41.3 (26.3 to 57.5) | |
| Physician and nurse | 9 | 7.4 (3.2 to 16.2) | 1 | 2.1 (0.3 to 13.5) | 8 | 13.4 (5.3 to 29.7) | |
| Physician and other person | 2 | 1.2 (0.3 to 4.8) | 0 | — | 2 | 2.6 (0.6 to 10.0) | |
*All percentages are adjusted for stratification and for patient and mortality characteristics of all deaths in 2007, which makes the percentages representative for all deaths in Flanders in 2007.
†P<0.05, using Fisher’s Exact (Monte Carlo).
‡One case was missing data on the variable “reporting of end of life decision.” Total numbers may not always amount to 137 because of rounding or missing values on variables. Percentages may not always amount to 100 because of rounding.
§ Neuromuscular relaxant alone or in conjunction with benzodiazepine, opioids, or other drug other than barbiturate.
¶Barbiturate alone or in conjunction with benzodiazepine, opioids, or other drug other than muscle relaxant.
**Neuromuscular relaxant and barbiturate, alone or in conjunction with benzodiazepine, opioids, or other drug.
††Opioids alone or in conjunction with benzodiazepine or other drug other than barbiturate or neuromuscular relaxant.