Background: Old age is often accompanied by disabilities and a reduced quality of life. Some elderly people consider this to be unacceptable and develop a wish to die.
Objective: To determine how often requests are made for physician-assisted death (PAD) in the absence of a severe illness, how such requests are dealt with in medical practice and what alternative care these patients receive in the Netherlands.
Methods: Retrospective interview study. Participants: 125 general practitioners (GPs), 77 nursing home physicians, and 208 clinical specialists.
Results: Approximately, thirty percent of all doctors in the Netherlands had at some time received an explicit request for PAD in the absence of a severe illness. Most requests for PAD to GPs in the absence of a severe illness were made by single people aged 80 and over. While their problems were most frequently of a social nature, 79% had one or more non-severe illnesses. Most GPs refused the request; half of them proposed an alternative treatment, which the patient often refused. Nineteen people who did not receive any treatment persisted in their wish to die; the request for PAD from 5 out of 10 patients who received one or more types of treatment was withdrawn or became less explicit.
Conclusions: Sometimes, old people who suffer from the consequences of old age request for PAD. Most doctors in the Netherlands refuse these requests. Most patients persist in their request. Palliative care focuses by WHO definition, in research and in practice on patients with life-threatening illness. Seemingly, if there would be more attention for older patients who are not seriously ill, especially in the sphere of spiritual care and pain relief, there could be a great improvement in their quality of life. This could prevent older patients to develop a death wish.