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  • Title: Influence of the metropolitan environment on end-of-life decisions: A population-based study of end-of-life decision-making in the Brussels metropolitan region and non-metropolitan Flanders.
    Author: Cohen J, Chambaere K, Bilsen J, Houttekier D, Mortier F, Deliens L.
    Journal: Health Place; 2010 Sep; 16(5):784-93. PubMed ID: 20430683.
    Abstract:
    Research is beginning to show differences between end-of-life care in metropolitan and non-metropolitan areas. Using population-based post-mortem surveys this article compares medical end-of-life decisions in the Brussels metropolitan area and non-metropolitan Flanders (Belgium). In Brussels, administering lethal drugs without an explicit patient request occurred more often, intensification of symptom alleviation and non-treatment decisions less often, and end-of-life treatment was more often aimed at cure or life prolongation, than in non-metropolitan Flanders. This paper argues that these differences in end-of-life decisions are related to characteristics of the metropolitan environment and hence may also apply in other metropolitan regions worldwide. Specific approaches to end-of-life decisions in metropolitan areas need to be considered.
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