Suicide, AssistedNCT06186791
Self-directed Dying in the Netherlands
An observational study of Suicide, Assisted and Fasting, run by Erasmus Medical Center at 1 site in Netherlands.
Trial summary
In 2007, the frequency of so-called 'self-directed dying' in the Netherlands was investigated, that is, the voluntary cessation of eating and drinking or the taking of lethal self-collected medication. This research has not been repeated yet. Read more about this study
- Who is it for?
- Ages 18 years and older
- Conditions the study is for
- Suicide, Assisted, Fasting, Decision Making
- How many people
- 37,500 participants
- Where
- 1 siteNetherlands
- Study dates
- 1 Jan 2024to 1 Oct 2024
- Phase
- Observational
- Are there results?
- None posted in the registry
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 18 years and older
- All sexes
- No healthy volunteers
- Adult, Older adult
Study population: A sample (n ≈ 37 500) of Dutch adults over the age of 18 will be randomly drawn from a large panel of adults willing to participate in questionnaire research. The panel is representative of the Dutch adult population in terms of gender, age, education and geographical location.
Who may be able to join
- Be 18 years or older
- Be able to speak and read Dutch
- Have given informed consent to participation
Who cannot join
- Younger than 18 years
- Not able to speak and read Dutch
- Not giving informed consent to participation
Trial locations and contacts
1 site in 1 country.
About this study
Official title: Self-directed Dying in the Netherlands by Voluntarily Stopping Eating and Drinking or Independently Intake of Lethal Medication Attended by a Confidant.
In 2007, the frequency of so-called 'self-directed dying' in the Netherlands was investigated, that is, the voluntary cessation of eating and drinking or the taking of lethal self-collected medication. This research has not been repeated yet. Since 2007 there have been major developments regarding assisted and non-assisted dying, including the issue of a guideline by the KNMG and the endorsement by various political parties of a proposal for a new law on assistance in dying. There has also been much societal debate on euthanasia and assisted suicide as regulated by the Termination of Life on Request and Assisted Suicide (Review Procedures) Act. These developments may have had an influence on the frequency of self-directed dying.
The primary objective of this cross-sectional questionnaire study with add-on qualitative interviews is to estimate how many people die each year in the Netherlands by either voluntarily stopping eating or drinking (VSED) or intentional intake of lethal medication attended by a confidant (ILMC). Secondary objectives include studying whether this number has changed since 2007; exploring possible explanations for changes in frequencies; and providing insight in the quality of dying of people who choose self-directed dying.
To this end an online questionnaire will be sent out to a randomly drawn sample (n ≈ 37 500) from a large representative panel (NIPObase) of the Dutch adult population. A two-stage screening procedure will be used to check whether the experiences of the respondents represent a death VSED or by ILMC. The data will be analysed using quantitative software SPSS. From the respondents who indicate that they are willing to be interviewed, a sample will be taken from each group, 20 from VSED and 20 from ILMC. Interviews will be conducted by an experienced interviewer. The interviews are focused on better understanding people's choice for a self-directed death and on the perceived quality of the dying process for both methods. The interviews will be audio recorded and thematically analysed using qualitative software (N-Vivo).
Read the detailed description
The frequency of both types of self-directed deaths in the population can be estimated with the standard weighting method that is used by Statistics Netherlands (CBS) in estimating the annual frequency of relatively rare events such as traffic incidents. The investigators will use an adapted standard weighting. Each informant is weighted by the inverse of 1 (the informant) plus the number of other individuals who had been confided by the deceased person about their intention to hasten death by VSED or ILMC. The estimated number of cases will be computed for the responding part of the sample. For the frequency estimation, the investigators will use the number of informants on a death by VSED or ILMC in the five years from 1 January 2018 to 31 December 2022, because reports about cases before 2018 are considered less reliable. The annual frequency of VSED and ILMC can then be computed as the estimated proportion of reported cases in the sample (i.e. weighted sum of informants on VSED deaths and ILMC deaths respectively divided by sample size corrected for non-response), multiplied by the total number of Dutch adults minus non-western adults (underrepresented in the sample) and divided by the five years covered by the informants. The Poisson distribution will be used in calculating the 95% Confidence Intervals (CIs).
Secondary outcomes will be mainly described in frequency tables, using standard statistical analysis.
The interview transcripts will be analysed thematically using NVivo software.
- Conditions
- Suicide, Assisted, Fasting, Decision Making
- Keywords
- Wish to hasten death, Voluntary stopping eating and drinking, Independently intake of lethal medication (attended by a confident), Self determination, Personal autonomy
- Medical subject headings
- Suicide, Assisted, Fasting
What is being measured
The primary outcome is the main question the study is designed to answer.
Frequency of annual self-directed deaths
An estimate of the number of people who die each year by voluntary stopping eating and drinking, and an estimate of the number of people who die each year by independent intake of lethal medication attended by a confidant.
Measured: January 2024 - March 2024
Secondary outcomes (3)
Comparison of estimates of self-directed deaths
A comparison of current estimates with the estimated numbers of self-directed deaths in 2007
Measured: May 2024
Changes in frequencies
An exploration of possible explanations for changes in frequencies
Measured: May - September 2024
Decision-making process and quality of dying
Providing insight in the decision-making process and the quality of dying of people who choose self-directed dying.
Measured: June - September 2024
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted2 Jan 2024
- Study start1 Jan 2024
- Primary completion1 Mar 2024
- Study completion1 Oct 2024
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Publications (2)Papers the sponsor has linked to this study.
- Other trials for Suicide, AssistedStudies of the same condition, open and under way.
- More trials run by Erasmus Medical CenterThe sponsor's other registered studies.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Observational
- Observational model
- Other
- Time perspective
- Cross-sectional
- Enrolment
- 37,500 participants (actual)
Sponsor and investigators
- Lead sponsor
- Erasmus Medical Center
- Sponsor type
- University, hospital or other
- Responsible party
- Principal investigator, Agnes van der Heide, Erasmus Medical Center
- Investigators
- Agnes van der Heide, prof. dr., Principal investigator, Erasmus Medical Center
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT06186791
- Sponsor's protocol ID
- 10894
- Status last verified
- Dec 2023
- First submitted
- 23 Oct 2023
- Last updated
- 11 Mar 2025
- Results posted
- No
- Data monitoring committee
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- Undecided
Publications
Chabot BE, Goedhart A. A survey of self-directed dying attended by proxies in the Dutch population. Soc Sci Med. 2009 May;68(10):1745-51. doi: 10.1016/j.socscimed.2009.03.005. Epub 2009 Apr 15.
PubMed 19375206Bosma F, Stoppelenburg A, van der Heide A, van de Vathorst S. Frequency of self-directed dying in the Netherlands: research protocol of a cross-sectional mixed-methods study. BMJ Open. 2024 Apr 29;14(4):e085240. doi: 10.1136/bmjopen-2024-085240.
PubMed 38684276
Study at a glance
From the registry record, last updated by the sponsor on 11 Mar 2025. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Self-directed Dying in the Netherlands by Voluntarily Stopping Eating and Drinking or Independently Intake of Lethal Medication Attended by a Confidant.
- ClinicalTrials.gov ID
- NCT06186791
- Acronym / sponsor ID
- 10894
- Conditions
- Suicide, Assisted, Fasting, Decision Making
- Keywords
- Wish to hasten death, Voluntary stopping eating and drinking, Independently intake of lethal medication (attended by a confident), Self determination, Personal autonomy
- Study type
- Observational
- Recruitment status
- Completed
- Enrolment
- 37,500 participants (actual)
- Lead sponsor
- Erasmus Medical CenterUniversity, hospital or other
- Study start
- 1 Jan 2024 (actual)
- Primary completion
- 1 Mar 2024 (actual)
- Study completion
- 1 Oct 2024 (actual)
- First posted
- 2 Jan 2024 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
In 2007, the frequency of so-called 'self-directed dying' in the Netherlands was investigated, that is, the voluntary cessation of eating and drinking or the taking of lethal self-collected medication. This research has not been repeated yet. Since 2007 there have been major developments regarding assisted and non-assisted dying, including the issue of a guideline by the KNMG and the endorsement by various political parties of a proposal for a new law on assistance in dying. There has also been much societal debate on euthanasia and assisted suicide as regulated by the Termination of Life on Request and Assisted Suicide (Review Procedures) Act. These developments may have had an influence on the frequency of self-directed dying.
The primary objective of this cross-sectional questionnaire study with add-on qualitative interviews is to estimate how many people die each year in the Netherlands by either voluntarily stopping eating or drinking (VSED) or intentional intake of lethal medication attended by a confidant (ILMC). Secondary objectives include studying whether this number has changed since 2007; exploring possible explanations for changes in frequencies; and providing insight in the quality of dying of people who choose self-directed dying.
To this end an online questionnaire will be sent out to a randomly drawn sample (n ≈ 37 500) from a large representative panel (NIPObase) of the Dutch adult population. A two-stage screening procedure will be used to check whether the experiences of the respondents represent a death VSED or by ILMC. The data will be analysed using quantitative software SPSS. From the respondents who indicate that they are willing to be interviewed, a sample will be taken from each group, 20 from VSED and 20 from ILMC. Interviews will be conducted by an experienced interviewer. The interviews are focused on better understanding people's choice for a self-directed death and on the perceived quality of the dying process for both methods. The interviews will be audio recorded and thematically analysed using qualitative software (N-Vivo).
Detailed description
The frequency of both types of self-directed deaths in the population can be estimated with the standard weighting method that is used by Statistics Netherlands (CBS) in estimating the annual frequency of relatively rare events such as traffic incidents. The investigators will use an adapted standard weighting. Each informant is weighted by the inverse of 1 (the informant) plus the number of other individuals who had been confided by the deceased person about their intention to hasten death by VSED or ILMC. The estimated number of cases will be computed for the responding part of the sample. For the frequency estimation, the investigators will use the number of informants on a death by VSED or ILMC in the five years from 1 January 2018 to 31 December 2022, because reports about cases before 2018 are considered less reliable. The annual frequency of VSED and ILMC can then be computed as the estimated proportion of reported cases in the sample (i.e. weighted sum of informants on VSED deaths and ILMC deaths respectively divided by sample size corrected for non-response), multiplied by the total number of Dutch adults minus non-western adults (underrepresented in the sample) and divided by the five years covered by the informants. The Poisson distribution will be used in calculating the 95% Confidence Intervals (CIs).
Secondary outcomes will be mainly described in frequency tables, using standard statistical analysis.
The interview transcripts will be analysed thematically using NVivo software.
Study design
- Observational model
- Other
- Time perspective
- Cross-sectional
Who may qualify
- Ages
- 18 years and older
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
- Study population
- A sample (n ≈ 37 500) of Dutch adults over the age of 18 will be randomly drawn from a large panel of adults willing to participate in questionnaire research. The panel is representative of the Dutch adult population in terms of gender, age, education and geographical location.
Key inclusion criteria (3 listed)
- Be 18 years or older
- Be able to speak and read Dutch
- Have given informed consent to participation
Key exclusion criteria (3 listed)
- Younger than 18 years
- Not able to speak and read Dutch
- Not giving informed consent to participation
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Primary outcome
Frequency of annual self-directed deaths
Time frame: January 2024 - March 2024
An estimate of the number of people who die each year by voluntary stopping eating and drinking, and an estimate of the number of people who die each year by independent intake of lethal medication attended by a confidant.
3 secondary outcomes
Comparison of estimates of self-directed deaths
Time frame: May 2024
Changes in frequencies
Time frame: May - September 2024
Decision-making process and quality of dying
Time frame: June - September 2024
Results and safety
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 11 Mar 2025.
- Background: PubMed 19375206Chabot BE, Goedhart A. A survey of self-directed dying attended by proxies in the Dutch population. Soc Sci Med. 2009 May;68(10):1745-51. doi: 10.1016/j.socscimed.2009.03.005. Epub 2009 Apr 15.
- Derived from this study: PubMed 38684276Bosma F, Stoppelenburg A, van der Heide A, van de Vathorst S. Frequency of self-directed dying in the Netherlands: research protocol of a cross-sectional mixed-methods study. BMJ Open. 2024 Apr 29;14(4):e085240. doi: 10.1136/bmjopen-2024-085240.
- Individual participant dataSharing planned: Undecided
Related trials for Suicide, Assisted
Active, not recruitingObservational study
Assisted Suicide in Switzerland
Assisted Suicide
Not yet recruitingPhase 1
ADEPT Psilocybin-Assisted Therapy With DBT for Borderline Personality Disorder
Borderline Personality Disorder, Borderline Personality Pathology
Recruiting
Technology-assisted Methods to Advance Suicide Prevention Among Youth in Colombia
Suicidal Ideations, Suicidal Behaviors
Not yet recruitingObservational study
User Evaluation Think Life
Suicidal Ideation, Suicide Prevention
Recruiting
Clinical Trial for Integrated Care to Help At Risk Teen (iCHART) Intervention
Suicide and Depression, Adolescent Behavior
Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
Agnes van der Heide, prof. dr. principal investigator
Erasmus Medical Center
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
An observational study of Suicide, Assisted and Fasting, run by Erasmus Medical Center at 1 site in Netherlands.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 3 inclusion and 3 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: finished, as of the sponsor's last update on 11 Mar 2025. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 1 site in Netherlands. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
Are results available for this study?
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Frequency of annual self-directed deaths (time frame: January 2024 - March 2024). It is what the study was designed to measure, not a finding.
Where can I read the original study information?
On the ClinicalTrials.gov record for NCT06186791, which also lists 2 linked publications.
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 11 Mar 2025.