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Euthanasia, Palliative Care Work in Unison in Belgium

While assisted dying is legal there, it's rarely implemented, expert says

THURSDAY, July 30 (HealthDay News) -- Legalizing euthanasia for terminally ill people doesn't lead to reduced use of palliative care, Belgian researchers say.

The team from the End-of-Life Care Research Group in Brussels also found that dying patients who received spiritual care in their final three months of life were more likely to choose euthanasia or physician-assisted suicide than those who received little or no spiritual care. The findings suggest that, instead of opposing each other, euthanasia and palliative care complement one another and often work in unison, said study author Lieve Van den Block and colleagues.

They looked at nearly 2,000 non-sudden deaths in Belgium in 2005-2006. Euthanasia is legal in Belgium, which also has a well-developed palliative care system. Of the patients included in the study, 32 percent were aged 85 or older, half were male, and cancer was the cause of death in 43 percent of the cases.

The researchers concluded that the use of specialist multidisciplinary palliative care was often associated with medical decisions to end a patient's suffering. There was no evidence that patients who don't use palliative care services are more likely to choose euthanasia, according to the report published in the July 31 online edition of BMJ.

While the findings provide "a valuable contribution to understanding the context of dying in Belgium," there are concerns about some of the conclusions being extrapolated from the study, Dr. Ira Byock, a director of a palliative medicine at Dartmouth-Hitchcock Medical Center in Lebanon, N.H., wrote in an accompanying editorial.

The study data showed that assisted dying is rarely performed in Belgium and "it would be a mistake to suggest that these findings dispel concerns about euthanasia or that they support including euthanasia within palliative care," Byock said.

More information

The Family Caregiver Alliance has more about end-of-life choices.

-- Robert Preidt

SOURCE: BMJ, news release, July 30, 2009

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