Background: In recent decades significant developments in end-of-life care have taken place
in The Netherlands. There has been more attention for palliative care and alongside the practice
of euthanasia has been regulated.
Objective: The aim of this paper is to describe the opinions of physicians with regard to
the relationship between palliative care and euthanasia, and determinants of these opinions.
Design: Cross-sectional.
Setting/subjects: Representative samples of physicians (n = 410), relatives of patients who
died after euthanasia and physician-assisted suicide (EAS; n = 87), and members of the Euthanasia
Review Committees (ERCs; n = 35).
Measurements: Structured interviews with physicians and relatives of patients, and a written
questionnaire for the members of the ERCs.
Results: Approximately half of the physicians disagreed and one third agreed with statements
describing the quality of palliative care in The Netherlands as suboptimal and describing
the expertise of physicians with regard to palliative care as insufficient. Almost two
thirds of the physicians disagreed with the suggestion that adequate treatment of pain and
terminal care make euthanasia redundant. Having a religious belief, being a nursing home
physician or a clinical specialist, never having performed euthanasia, and not wanting to perform
euthanasia were related to the belief that adequate treatment of pain and terminal care
could make euthanasia redundant.
Conclusion: The study results indicate that most physicians in The Netherlands are not convinced
that palliative care can always alleviate all suffering at the end of life and believe that
euthanasia could be appropriate in some cases.
