ArticleAge and ageing2026
Euthanasia in advanced dementia: an empirical study of the decision-making process based on advance directives.
Article in Age and ageing, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
7 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundIn the Netherlands, euthanasia or physician-assisted suicide are criminal offences, yet physicians may be exempt from prosecution if they meet statutory due care criteria. This exemption also applies in situations where a written advance euthanasia directive (AED) is relied upon after decision-making capacity is lost. Although such cases are rare, it remains unclear how physicians, other healthcare professionals and relatives interpret and translate written wishes into ethically and legally defensible practice.
methodsWe conducted a qualitative case study of 14 real-life AED-based euthanasia cases-seven performed and seven forgone-using semi-structured interviews with 21 stakeholders (14 physicians, 10 other healthcare professionals, 5 relatives). Data were analysed with constant-comparison and framework analysis until saturation.
resultsFive interrelated considerations guided each decision-making process: weighing the AED, assessing current wishes, the elusive nature of unbearable suffering, exploring alternatives and putting plans into action. Four contextual factors shaped judgement across cases: the physician-patient relationship, record-keeping, professional experience and seeking validation from others.
conclusionDecision-making on AED-based euthanasia is layered and uncertain, requiring physicians to weigh the patient's earlier written wishes against present expressions, observable suffering and input from others; when these elements cannot be brought together, participants deem euthanasia ethically unjustifiable.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.