Doctors in the Netherlands compared the experience of 189 family members and close friends of terminal cancer patients who had died as a result of euthanasia with those of 316 whose relations or friends had died naturally. The bereaved filled in questionnaires that can be used to produce a “score” for symptoms of grief, post-traumatic stress, well-being and depression.

The results, reported in the British Medical Journal, showed that euthanasia left the survivors with lower levels of both grief and stress, and little or no difference on the well-being or depression scale.

In the Netherlands 3,200 patients die by euthanasia every year, 80 per cent of them suffering from terminal cancer. About half of all cancer patients die at home, rather than in a hospital or a hospice.

The team, led by Dr Nikkie Swarte, of the University Medical Centre in Utrecht, suggest that families of those who die by euthanasia have a better chance to say goodbye, are more prepared when death occurs, and have probably talked openly with the patient about death. Cancer patients who do not opt for euthanasia may be in denial and their families may have colluded in this denial, making it harder to grieve afterwards.

“There is a need for open awareness of impending death and for careful and thoughtful planning of where and how the death ought to occur,” the team say. They insist, however, that the results should not be interpreted as a plea for euthanasia, but a call for the same care and openness in all terminally ill patients.

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