Published 14 September 2009, doi:10.1136/bmj.b3687
Cite this as: BMJ 2009;339:b3687

Letters

End of life decisions

Authors respond to editorial

The first 150 words of the full text of this article appear below.

In the editorial accompanying our study, Byock says that we focus on practices that rarely occur at the end of life, such as euthanasia and physician assisted suicide, and pay little attention to more common decisions.^{1 2} However, detailed empirical reporting is necessary because of the intense societal, legal, and ethical debates about these decisions. Additionally, although some decisions such as life ending drug use without explicit patient request and palliative sedation are not common in palliative care overall, they are more common than outside palliative care.

The classification system we used has been validated and used extensively in international research.^{3 4} It distinguishes specifically between distinct actions and intentions, as described in detail in the methods section.

"Principles do not depend on empirical data,"¹ but our study provides empirical data on a subject that has been dominated by emotional unproved arguments. Although many people believe that euthanasia requests follow a lack . . . [Full text of this article]

¹ Vrije Universiteit Brussel, End-of-Life Care Research Group, Laarbeeklaan 103, 1090 Brussels, Belgium, ² Scientific Institute of Public Health, Department of Epidemiology, 1040 Brussels

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