Legal euthanasia in Belgium: characteristics of all reported euthanasia cases.

OBJECTIVES To study the reported medical practice of euthanasia in Belgium since implementation of the euthanasia law. RESEARCH DESIGN Analysis of the anonymous database of all euthanasia cases reported to the Federal Control and Evaluation Committee Euthanasia. SUBJECTS All euthanasia cases reported by physicians for review between implementation of the euthanasia law on September 22nd, 2002 and December 31, 2007 (n = 1917). MEASURES Frequency of reported euthanasia cases, characteristics of patients and the decision for euthanasia, drugs used in euthanasia cases, and trends in reported cases over time. RESULTS The number of reported euthanasia cases increased every year from 0.23% of all deaths in 2002 to 0.49% in 2007. Compared with all deaths in the population, patients who died by euthanasia were more often younger (82.1% of patients who received euthanasia compared with 49.8% of all deaths were younger than 80, P < 0.001), men (52.7% vs. 49.5%, P = 0.005), cancer patients (82.5% vs. 23.5%, P < 0.001), and more often died at home (42.2% vs. 22.4%, P < 0.001). Euthanasia was most often performed with a barbiturate, sometimes in combination with neuromuscular relaxants (92.4%) and seldom with morphine (0.9%). In almost all patients, unbearable physical (95.6%) and/or psychological suffering (68%) were reported. A small minority of cases (6.6%) concerned nonterminal patients, mainly suffering from neuromuscular diseases. CONCLUSIONS The frequency of reported euthanasia cases has increased every year since legalization. Euthanasia is most often chosen as a last resort at the end of life by younger patients, patients with cancer, and seldom by nonterminal patients.