Endoflifebeleid

Endoflifebeleid is the term used to describe the policy framework that governs end-of-life care within health systems and institutions in Dutch-speaking contexts. It covers the planning, delivery, oversight, and governance of care for people nearing the end of life, with the aims of alleviating suffering, preserving dignity, and respecting patient preferences.

Core elements include advance care planning and advance directives, which document a person’s goals and consent in case of diminished decision-making capacity; clear communication about prognosis and goals of care; decisions to withhold or withdraw life-sustaining treatments when these are not aligned with the patient’s goals; do-not-resuscitate orders; and the provision of palliative care throughout the illness trajectory, including symptom management and, when appropriate, palliative sedation. Many policies also address home-based and hospice care, as well as the possible withdrawal of artificial nutrition and hydration.

Legal and ethical contexts differ by country. In some places, physician-assisted dying or euthanasia is legally regulated with safeguards; in others it remains illegal. End-of-life policy thus interacts with national laws, professional guidelines, and institutional policies.

Implementation involves trained professionals, multidisciplinary teams, ethics input, and patient- and family-centered approaches. Safeguards include capacity assessment, informed consent, second opinions, documentation, and ongoing quality monitoring.

Challenges include ensuring equitable access, cultural and religious considerations, and balancing patient autonomy with professional ethics. Ongoing policy development aims to integrate palliative care early, improve communication, and expand access to high-quality end-of-life care.