{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T09:16:07Z","timestamp":1790068567539,"version":"4.0.1"},"reference-count":34,"publisher":"SAGE Publications","issue":"4","license":[{"start":{"date-parts":[[2026,2,14]],"date-time":"2026-02-14T00:00:00Z","timestamp":1771027200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,2,14]],"date-time":"2026-02-14T00:00:00Z","timestamp":1771027200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"DOI":"10.13039\/501100000781","name":"European Research Council","doi-asserted-by":"publisher","award":["771483"],"award-info":[{"award-number":["771483"]}],"id":[{"id":"10.13039\/501100000781","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Palliat Med"],"published-print":{"date-parts":[[2026,4]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Discussing end-of-life care with people with dementia and their family soon after diagnosis is a crucial aspect of professional care. Research in the hospital setting is scarce.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Aim:<\/jats:title>\n                    <jats:p>To investigate how often end-of-life issues and euthanasia are discussed during hospital consultations with people with dementia; identify who initiates these conversations; explore physicians\u2019 perceptions of their own role in these conversations compared to actual practice and physicians\u2019 views on the family\u2019s involvement.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design:<\/jats:title>\n                    <jats:p>Convergent mixed-method study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting\/participant:<\/jats:title>\n                    <jats:p>11\u2009Dutch hospitals involving 31 physicians.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>End-of-life topics were discussed in 36% of consultations (in regional hospitals, 53%; in academic settings, 27%), and predominantly during diagnostic consultations (54%). Euthanasia was discussed in 21%, often initiated by the patient (60%) or the family (31%). Family members were present in 96% of consultations. We identified 3 themes. (1) Struggle to initiate end-of-life conversations. Physicians acknowledged the importance of timely end-of-life discussions, but struggled to initiate those discussions. Introducing euthanasia is considered undesirable. (2) Appreciation and concern about family input. Physicians\u2019 experiences of family involvement were positive in both end-of-life and euthanasia conversations, yet the latter also raised concerns. (3) Moral concerns regarding euthanasia for dementia. Physicians emphasized the importance of raising patient awareness about other end-of-life options.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions and relevance:<\/jats:title>\n                    <jats:p>End-of-life conversations with patients with dementia are not standard practice in the hospital setting. The availability of euthanasia can narrow patients\u2019 perspective on other end-of-life options. This hinders physicians from initiating end-of-life conversations and possibly end-of-life decision making and care.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/02692163261416275","type":"journal-article","created":{"date-parts":[[2026,2,14]],"date-time":"2026-02-14T15:10:21Z","timestamp":1771081821000},"page":"546-555","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":2,"title":["Bringing up the end of life and euthanasia. A mixed method study on consultations with people with dementia and their families in the hospital setting"],"prefix":"10.1177","volume":"40","author":[{"ORCID":"https:\/\/orcid.org\/0009-0007-0629-4141","authenticated-orcid":false,"given":"Trijntje M.","family":"Scheeres-Feitsma","sequence":"first","affiliation":[{"name":"Protestant Theological University, Utrecht, The Netherlands"},{"name":"Department of Public Health and Primary Care, Leiden University Medical Center, The Netherlands"},{"name":"Hanze, University of Applied Sciences, Groningen, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Petruschka","family":"Schaafsma","sequence":"additional","affiliation":[{"name":"Protestant Theological University, Utrecht, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Janneke","family":"van Kempen","sequence":"additional","affiliation":[{"name":"Department of Geriatrics, Amphia Hospital, Breda, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9063-7501","authenticated-orcid":false,"given":"Jenny T.","family":"van der Steen","sequence":"additional","affiliation":[{"name":"Department of Public Health and Primary Care, Leiden University Medical Center, The Netherlands"},{"name":"Department of Primary and Community Care, Radboud university medical center, Nijmegen, The Netherlands"},{"name":"Radboudumc Alzheimer Center, Nijmegen, The Netherlands"},{"name":"Cicely Saunders Institute, King\u2019s College London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,2,14]]},"reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.12968\/ijpn.2017.23.9.446"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1177\/0269216314526272"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12904-018-0332-2"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1002\/alz.13526"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpainsymman.2024.05.028"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpainsymman.2025.02.471"},{"key":"e_1_3_2_8_2","unstructured":"Richtlijn Dementie Federatie Medisch Specialisten. https:\/\/richtlijnendatabase.nl\/richtlijn\/dementie\/startpagina_-_dementie_.html (2002 accessed 23 June 2025)."},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijnurstu.2020.103576"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0198535"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.3233\/JAD-131967"},{"key":"e_1_3_2_12_2","doi-asserted-by":"publisher","DOI":"10.1093\/ageing\/afac310"},{"key":"e_1_3_2_13_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2020-038528"},{"key":"e_1_3_2_14_2","doi-asserted-by":"publisher","DOI":"10.1046\/j.1525-1497.2003.21215.x"},{"issue":"4","key":"e_1_3_2_15_2","first-page":"757","article-title":"Dying Well-Informed: the need for better clinical education surrounding facilitating end-of-life conversations","volume":"92","author":"Sutherland R.","year":"2019","unstructured":"Sutherland R. 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