Self-directed Dying in the Netherlands

NCT06186791 | Completed

• 1 other identifier: 10894
• Study Type: observational
• Target: 37,500
• Locations: 1 country
• Sites: 1

Brief Summary

In 2007, the frequency of so-called 'self-directed dying' in the Netherlands was investigated, that is, the voluntary cessation of eating and drinking or the taking of lethal self-collected medication. This research has not been repeated yet. Since 2007 there have been major developments regarding assisted and non-assisted dying, including the issue of a guideline by the KNMG and the endorsement by various political parties of a proposal for a new law on assistance in dying. There has also been much societal debate on euthanasia and assisted suicide as regulated by the Termination of Life on Request and Assisted Suicide (Review Procedures) Act. These developments may have had an influence on the frequency of self-directed dying. The primary objective of this cross-sectional questionnaire study with add-on qualitative interviews is to estimate how many people die each year in the Netherlands by either voluntarily stopping eating or drinking (VSED) or intentional intake of lethal medication attended by a confidant (ILMC). Secondary objectives include studying whether this number has changed since 2007; exploring possible explanations for changes in frequencies; and providing insight in the quality of dying of people who choose self-directed dying. To this end an online questionnaire will be sent out to a randomly drawn sample (n ≈ 37 500) from a large representative panel (NIPObase) of the Dutch adult population. A two-stage screening procedure will be used to check whether the experiences of the respondents represent a death VSED or by ILMC. The data will be analysed using quantitative software SPSS. From the respondents who indicate that they are willing to be interviewed, a sample will be taken from each group, 20 from VSED and 20 from ILMC. Interviews will be conducted by an experienced interviewer. The interviews are focused on better understanding people's choice for a self-directed death and on the perceived quality of the dying process for both methods. The interviews will be audio recorded and thematically analysed using qualitative software (N-Vivo).

Conditions

Suicide, Assisted; Fasting; Decision Making

Keywords

Wish to hasten death; Voluntary stopping eating and drinking; Independently intake of lethal medication (attended by a confident); Self determination; Personal autonomy

Outcome Measures

Primary Outcomes (1)

• Frequency of annual self-directed deaths

  An estimate of the number of people who die each year by voluntary stopping eating and drinking, and an estimate of the number of people who die each year by independent intake of lethal medication attended by a confidant.

  January 2024 - March 2024

Secondary Outcomes (3)

• Comparison of estimates of self-directed deaths

  May 2024

• Changes in frequencies

  May - September 2024

• Decision-making process and quality of dying

  June - September 2024

Eligibility Criteria

• Age: 18 Years+
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)
• Sampling Method: Probability Sample

Study Population

A sample (n ≈ 37 500) of Dutch adults over the age of 18 will be randomly drawn from a large panel of adults willing to participate in questionnaire research. The panel is representative of the Dutch adult population in terms of gender, age, education and geographical location.

You may qualify if:

• Be 18 years or older
• Be able to speak and read Dutch
• Have given informed consent to participation

You may not qualify if:

• Younger than 18 years
• Not able to speak and read Dutch
• Not giving informed consent to participation

Sponsors & Collaborators

• Erasmus Medical Center: lead

Study Sites (1)

Erasmus University Medical Center

Rotterdam, 3015GD, Netherlands

Location

Related Publications (2)

• Chabot BE, Goedhart A. A survey of self-directed dying attended by proxies in the Dutch population. Soc Sci Med. 2009 May;68(10):1745-51. doi: 10.1016/j.socscimed.2009.03.005. Epub 2009 Apr 15.

  PMID: 19375206 BACKGROUND

• Bosma F, Stoppelenburg A, van der Heide A, van de Vathorst S. Frequency of self-directed dying in the Netherlands: research protocol of a cross-sectional mixed-methods study. BMJ Open. 2024 Apr 29;14(4):e085240. doi: 10.1136/bmjopen-2024-085240.

  PMID: 38684276 DERIVED

MeSH Terms

Conditions

Suicide, Assisted; Fasting

Condition Hierarchy (Ancestors)

Suicide; Self-Injurious Behavior; Behavioral Symptoms; Behavior; Feeding Behavior

Study Officials

• Agnes van der Heide, prof. dr.

  Erasmus Medical Center

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: observational
• Observational Model: OTHER
• Time Perspective: CROSS SECTIONAL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Prof. dr.

Study Record Dates

• First Submitted: October 23, 2023
• First Posted: January 2, 2024
• Study Start: January 1, 2024
• Primary Completion: March 1, 2024
• Study Completion: October 1, 2024
• Last Updated: March 11, 2025

Record last verified: 2023-12

Locations

NL (1)