End of life care and decision making: Opinions and experiences of the general public, bereaved relatives, and professionals

NJH Raijmakers

Research output: ThesisPhd-Thesis - Research and graduation external


End-of-life care aims to improve quality of life of patients and their relatives facing problems associated with life-threatening illness in the last days of life. End-of-life decision-making is an important aspect of end-of-life care that can have a significant impact on the process of dying and dying patients’ comfort in the last days of life. Moreover, end-of-life decisions are known to occur in 23-51% of all deaths in Europe and are subject to societal debate. Better understanding of current public opinion on end-of-life decisions can strengthen the societal debate in the Netherlands. End-of-life decision-making regarding artificial nutrition and hydration at the end of life is internationally shared to be important and better understanding can contribute to better end-of-life care. The aim of this thesis was to contribute to better understanding of end-of-life decision-making practices. One of the findings is that there is ample support for the Dutch Euthanasia Act, both among the general public and healthcare professionals, especially in the presence of physical symptoms. Both the general public and professionals consider euthanasia more problematic if a patient’s unbearable suffering is rooted in psychosocial problems or spiritual issues. Furthermore, at this moment providing artificial nutrition and hydration at the end of life is a frequent practice, although the effects on comfort seem limited. End-of-life decision-making regarding artificial nutrition and hydration can substantially improve by more evidence-based guidance, in which special attention is needed for communication about the impact of nutrition and hydration at the end of life.
Original languageEnglish
QualificationDoctor of Philosophy
Awarding Institution
  • Erasmus University Rotterdam
  • van der Heide, Agnes, Supervisor, External person
  • van Delden, J.J.M., Supervisor, External person
  • Rietjens, Judith A.C., Co-supervisor, External person
  • van Zuylen, Lia, Co-supervisor
Award date5 Jun 2013
Publication statusPublished - 2013
Externally publishedYes

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