Work

Euthanasia requests in Dutch people with Parkinsonian disorders: a qualitative study on the experiences of healthcare professionals

Year: 2026

Type: article

Abstract: Background In the Netherlands, over 60,000 individuals live with Parkinson’s disease (PD) and atypical parkinsonism (AP). As these chronic diseases progress, treatment goals gradually shift toward palliative care. This transition includes conversations among healthcare professionals (HCP), people with AP/PD, and informal caregivers, known as Advance Care Planning (ACP). Some individuals consider euthanasia or physician assisted suicide (PAS). Euthanasia and PAS is legally possible in the Netherlands since 2002 under The Termination of Life on Request and Assisted Suicide Act, provided that strict legal criteria are met. After euthanasia, the procedures are subject to review by regional euthanasia review committees. However, it is unclear when HCP consider ACP conversations appropriate, how they view euthanasia and PAS in AP/PD, and how they experience euthanasia requests. Some hesitate because cognitive decline in patients might be involved. Objective This study aims to understand Dutch HCP experiences with ACP and euthanasia and PAS requests in people with AP/PD and explores their thoughts, feelings, and opinions when confronted with requests for euthanasia or PAS. Method We conducted a qualitative study using eight closed and open questions focused specifically on experience with requests among HCP that volunteered to participate after completing a blended learning program on palliative care. HCP were also invited through announcements by professional organizations. Results Sixty respondents completed the questionnaire. Half were elderly care physicians, followed by neurologists and nurse practitioners involved in AP/PD care. One quarter had recently cared for a person with AP/PD who died, and over one-third had received at least one euthanasia request. Based on the qualitative responses, we identified three overarching themes: End-of-life communication, encompassing content of conversation, timing of ACP conversations; Knowledge and Collaboration, following guidelines, consultation, transmural collaboration referral to Dutch Euthanasia Expertise Centre; Opinions of HCP, reflecting personal perspectives on euthanasia, empathy for and assessment of unbearable suffering, role perception and legal implications. Conclusion HCP acknowledge the importance of end-of-life conversations but often hesitate to proactively address euthanasia and physician assisted suicide. Legislation, HCP’s personal beliefs, and professional roles influence these conversations. Respondents expressed a need for experiential learning and collaboration with experienced colleagues.

Source: BMC Palliative Care

DOI: 10.1186/s12904-026-02270-2

Authors: Laura E. Daeter, Herma Lennaerts, Anke Elbers, Elise G. P. Dopper, Marieke Groot