Study Shows Families Grieve Less Following Euthanasia Death

Bioethics   |   Steven Ertelt   |   Jul 20, 2003   |   9:00AM   |   WASHINGTON, DC

Study Shows Families Grieve Less Following Euthanasia Death

by Jill Boughton Staff Writer
July 20, 2003

London, England ( — Proponents of "happy death" (the literal meaning of "euthanasia") at the hands of physicians may find fresh ammunition in a study published in the July 26 issue of the British Medical Journal which found that "the bereaved family and friends of cancer patients who died by euthanasia coped better with respect to grief symptoms and post-traumatic stress reactions than the bereaved of comparable cancer patients who died a natural death."

However, the authors of the Dutch study state, "These results
should not be interpreted as a plea for euthanasia, but as a plea
for the same level of care and openness in all patients who are
terminally ill."

Surprising? Not to Thomas Marzen, General Counsel for the
National Legal Center for the Medically Dependent and Disabled.

He tells, "The major conclusion of the Dutch study appears to be that families of euthanized patients are more ’emotionally prepared’ for the patients’ deaths than families of patients who die without a lethal injection or overdose. This is hardly a surprise. One also supposes that families are more emotionally prepared for the death of a member who had been scheduled for execution than for the death of a member in an auto accident."

Euthanasia under controlled conditions is legal in the Netherlands and does in about 3200 people a year, of whom 80% have cancer. It differs from physician-assisted suicide, where the lethal agent is prescribed by a physician but taken directly by the patient.  This particular study also defined euthanasia in such a way as to exclude the significant number of Dutch patients who are put to death without their consent.

Until this study, no research had been done on how the way
patients choose to die affects their families.

Subjects of the study were 505 bereaved family members and close
friends of 172 cancer patients who died in the University Medical
Center, Utrecht, between 1992 and 1999. (The authors note that
many Dutch patients choose to die at home, and their experience
may be different from these subjects who died in the

About one-third of these patients were killed by their doctors at their request; the other 114 chose to let their cancer take its natural course.

Using questionnaires that measure such things as traumatic
grief, depression and general well-being, researchers tested the
hypothesis that euthanasia, like suicide, is an "unnatural death"
that may cause severe grief reactions. On the contrary, they
found that relatives of cancer patients who died a natural death
actually experienced more severe grief than those who were

Specific questions about the circumstances of death revealed
that those whose loved one chose euthanasia liked knowing the
exact time of death and being able to say goodbye while the
patient was fully alert. By contrast, many of those in the
"control" group either denied that death was imminent or never
got around to talking openly with their relative about it.

Although the patients from the two groups were "matched"
according to age, gender and year of death, there were some
differences. For example, those who died from euthanasia had the
surveys answered by more distant relatives (friends or cousins
rather than siblings or children), and these relatives tended to
be more educated and less religious.

Dr. Jay Brooks, chief of hematology and oncology at Ochsner
Clinic Foundation Hospital in New Orleans, stresses the
importance of such differences. He says "This kind of work is
hard because there are so many variables in a patient’s and
family’s background and their perception of death."

Brooks points out that people in the United States don’t like
to talk about death. Consequently, "As a country, we don’t die
well." Many people don’t take advantage of hospice services,
which "not only helps the person dying, but it helps the family
prepare for the inevitable separation," according to Brooks.

So does this study support the conclusion that everyone would
be happier if our society adopted a more permissive policy toward

Rather, it points out that we who affirm the absolute value
of all human life–from conception to natural death–may have
something to learn from those who advocate euthanasia. Family
members should be deliberate and courageous in preparing for and
facing death together, however long it takes.