ArticlePalliative medicine2026
Bringing up the end of life and euthanasia. A mixed method study on consultations with people with dementia and their families in the hospital setting.
Article in Palliative medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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4 authors.
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Abstract
backgroundDiscussing end-of-life care with people with dementia and their family soon after diagnosis is a crucial aspect of professional care. Research in the hospital setting is scarce.
aimTo investigate how often end-of-life issues and euthanasia are discussed during hospital consultations with people with dementia; identify who initiates these conversations; explore physicians' perceptions of their own role in these conversations compared to actual practice and physicians' views on the family's involvement.
designConvergent mixed-method study.Setting/participant:11 Dutch hospitals involving 31 physicians.
resultsEnd-of-life topics were discussed in 36% of consultations (in regional hospitals, 53%; in academic settings, 27%), and predominantly during diagnostic consultations (54%). Euthanasia was discussed in 21%, often initiated by the patient (60%) or the family (31%). Family members were present in 96% of consultations. We identified 3 themes. (1) Struggle to initiate end-of-life conversations. Physicians acknowledged the importance of timely end-of-life discussions, but struggled to initiate those discussions. Introducing euthanasia is considered undesirable. (2) Appreciation and concern about family input. Physicians' experiences of family involvement were positive in both end-of-life and euthanasia conversations, yet the latter also raised concerns. (3) Moral concerns regarding euthanasia for dementia. Physicians emphasized the importance of raising patient awareness about other end-of-life options. CONCLUSIONS AND RELEVANCE: End-of-life conversations with patients with dementia are not standard practice in the hospital setting. The availability of euthanasia can narrow patients' perspective on other end-of-life options. This hinders physicians from initiating end-of-life conversations and possibly end-of-life decision making and care.
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