BMJ  2008;336:864-867 (19 April), doi:10.1136/bmj.39497.397257.AD

Analysis

Development of palliative care and legalisation of euthanasia: antagonism or synergy?

¹ End of Life Care Research Group, Department of Medical Sociology and Health Sciences, Vrije Universiteit Brussel, Laarbeeklaan 103, 1090 Brussels, Belgium, ² Department of Human Ecology, Vrije Universiteit Brussel, ³ Department of Palliative Care, Oncological Centre, AZ, Vrije Universiteit Brussel , ⁴ Federation Palliative Care Flanders, Wemmel, Belgium, ⁵ Department of Public and Occupational Health, EMGO Institute, VU University Medical Centre Amsterdam, Netherlands

Debates about euthanasia often polarise opinion, but Jan Bernheim and colleagues describe how in Belgium the two camps grew up side by side to mutual benefit

Although palliative care and legalised euthanasia are both based on the medical and ethical values of patient autonomy and caregiver beneficence and non-maleficence,¹ they are often viewed as antagonistic causes. A popular perception, for instance, is that palliative care is the province of religiously motivated people and the advocacy of euthanasia that of agnostics or atheists.^{2 3} The European Association for Palliative Care has voiced concerns that legalising euthanasia would be the start of a slippery slope resulting in harm to vulnerable patients such as elderly and disabled people and that it would impede the development of palliative care by appearing as an alternative.⁴ Data from the Netherlands and Belgium, where euthanasia is legal, do not provide any evidence of a slippery slope.^{5 6} Here, we focus on the effect of the process of legalisation of euthanasia on palliative care and vice versa by reviewing the published historical, regulatory, and epidemiological evidence . . . [Full text of this article]

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Rapid Responses:

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euthanasia and palliative care: not so good

Alvaro Sanz, et al.
bmj.com, 20 Apr 2008 [Full text]

Re: euthanasia and palliative care: not so good

Lesley A M Evans
bmj.com, 21 Apr 2008 [Full text]

The hidden agenda of Euthanasia

Dr Nicholas Herodotou
bmj.com, 21 Apr 2008 [Full text]

The third face of the card

Hector R. Diaz
bmj.com, 22 Apr 2008 [Full text]

No slippery slope?

John C Chambers
bmj.com, 22 Apr 2008 [Full text]

Synergy between Palliative Care and Euthanasia in Belgium: a non-proved hypothesis

Carlos Centeno
bmj.com, 23 Apr 2008 [Full text]

No role for the dying patient`s wishes?

Donald C Aston
bmj.com, 24 Apr 2008 [Full text]

This is not good science

Isabel G Neto
bmj.com, 24 Apr 2008 [Full text]

Can Palliative Care and euthanasia really be developed together? Some thoughts from the UK.

Jane Gibbins, et al.
bmj.com, 24 Apr 2008 [Full text]

Evidence in Support

Isky Gordon
bmj.com, 24 Apr 2008 [Full text]

Evidence of slippery slope, lack of logic and absence of decency

Marta Munzarova
bmj.com, 28 Apr 2008 [Full text]

euthanasia

David J Evans
bmj.com, 29 Apr 2008 [Full text]

unacceptable

jr hunter
bmj.com, 1 May 2008 [Full text]

In Reply to Senteno's 'Synergy between Palliative Care and Euthanasia in Belgium: a non-proved hypothesis

Jan L Bernheim, et al.
bmj.com, 7 May 2008 [Full text]

In reply to Sanz and Del Valle's Euthanasia and palliative care: not so good

Jan L Bernheim, et al.
bmj.com, 2 May 2008 [Full text]

Re: unacceptable

Michael O'Donnell
bmj.com, 2 May 2008 [Full text]

Re: The hidden agenda of Euthanasia

Jan L Bernheim, et al.
bmj.com, 2 May 2008 [Full text]

Authors' replies to four responses

Jan L Bernheim, et al.
bmj.com, 2 May 2008 [Full text]

Re: Can Palliative Care and euthanasia really be developed together? Some thoughts from the UK.

Jan L Bernheim, et al.
bmj.com, 2 May 2008 [Full text]

Facts and figures do not fit in with the “palliative care-euthanasia synergy” philosophy

Marco Maltoni, et al.
bmj.com, 8 May 2008 [Full text]

Re: Evidence of slippery slope, lack of logic and absence of decency

Jan L Bernheim, et al.
bmj.com, 12 May 2008 [Full text]

In reply to Maltoni et al.'s Facts and figures do not fit in with the “palliative care-euthanasia synergy” philosophy

Jan L Bernheim, et al.
bmj.com, 20 May 2008 [Full text]

Re: Euthanasia by David Evans

John C Chambers
bmj.com, 3 Jun 2008 [Full text]

Religiosity and Euthanasia: in reply to Drs Chambers & Evans

Jan L Bernheim, et al.
bmj.com, 25 Jun 2008 [Full text]