Euthanasia

Jan Gilby (Letters, March 6) says that the Flanders survey I referred to in my letter of February 28 had been revisited which gave a different result. In the second survey, physicians had explained the deaths as ‘‘palliative sedation’’ and ‘‘symptom treatment’’.

However, the researchers sounded a warning. They wrote:

‘‘We used robust source data obtained with rigorous methods that guaranteed anonymity and produced a reasonable response rate despite the medicolegal sensitivity of the subject. However, we cannot exclude some degree of nonresponse bias. Desirability biases in the source data are possible; despite strict anonymity, some physicians may not have reported life-ending acts without explicit patient request in the survey. Only the physicians’ perspectives were studied. In addition, surveys are inevitably reductionist, and cannot fully capture the complexity and diversity of clinical cases and doctor– patient interactions at the end of life. Providing an options list for the term that best described physicians’ acts may have introduced bias, though there was the possibility of a free text answer. Finally, we cannot exclude the possibility of poor recall in physicians’ reporting, particularly of drugs and doses where missing data may have biased the results.’’

I refer again to the article on the illusion of safeguards and controls: ‘‘Legalizing euthanasia or assisted suicide: the illusion . . . – Parliament’’. John Fong

Hamilton

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