Granted, Undecided, Withdrawn, and Refused Requests for Euthanasia and Physician-Assisted Suicide

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Abstract
In many areas of the world physicians have to deal with requests for euthanasia and physician-assisted suicide (EAS).1-8 In Oregon, Belgium, and the Netherlands, physicians are allowed to perform euthanasia (Belgium and the Netherlands) or physician-assisted suicide (Oregon and the Netherlands).9-11 The Dutch notification procedure stipulates the official requirements for accepted practice that the patient’s situation should meet for the physician not to be prosecuted (no alternatives for treatment, well-considered explicit request, unbearable and hopeless suffering, and consultation of a colleague).11 Therefore, in deciding whether to grant a request, physicians should determine whether these requirements are met and be reluctant to grant a request if the patient’s situation does not meet these requirements. Not meeting the requirements should be a reason for refusing a request. In the time between an EAS request and a decision, several types of situations can arise.3,12 Patients can die a natural death before the performance of EAS or before the final decision is made or the patient can withdraw the request. Although several studies,3,13-21 especially in the United States and the Netherlands, have focused on the characteristics of patients who request EAS and the reasons for their request, only one study3 distinguished between these different possible situations, albeit without describing the characteristics of the different groups.