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ARTICLE Medical End-of-Life Decisions in Children in Flanders, Belgium A Population-Based Postmortem Survey Geert Pousset, MA; Johan Bilsen, PhD; Joachim Cohen, PhD; Kenneth Chambaere, MA; Luc Deliens, PhD; Freddy Mortier, PhD Objectives: To estimate the prevalence of end-of-life life-shortening effect in 18.2% of all deaths, nontreat- decisions and to describe their characteristics and the pre- ment decisions were made in 10.3%, and lethal drugs with- ceding decision-making process in minors in Belgium. out the patient’s explicit request were used in 7.9%. No cases of euthanasia, ie, the use of drugs with the explicit Design: Population-based postmortem anonymous phy- intention to hasten death at the patient’s explicit re- sician survey. quest, were reported. Poor clinical prospects (84.6%) and low quality of life expectations (61.5%) were important Setting: Flanders, Belgium. reasons for the physicians to engage in end-of-life deci- sions. Parents were involved in decision making in 85.2% Participants: All physicians signing the death certifi- of these decisions, patients in 15.4%. cates of all patients (N=250) aged 1 to 17 years who died between June 2007 and November 2008 in Flanders, Bel- Conclusions: Medical end-of-life decisions are fre- gium. quent in minors in Flanders, Belgium. Whereas parents were involved in most
JAMA Pediatrics – American Medical Association
Published: Jun 1, 2010
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