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\"This book is the first comprehensive report and analysis of the Dutch euthanasia experience over the last three decades. In contrast to most books about euthanasia, which are written by authors from countries where the practice is illegal and therefore practiced only secretly, this book analyzes empirical data and real-life clinical behavior. Its essays were written by the leading Dutch scholars and clinicians who shaped euthanasia policy and who have studied, evaluated, and helped regulate it. Some of them have themselves practiced euthanasia. The book will contribute to the world literature on physician-assisted death by providing a comprehensive examination of how euthanasia has been practiced and how it has evolved in one specific national and cultural context. It will greatly advance the understanding of euthanasia among both advocates and opponents of the practice\"--Provided by publisher.

Although much research has been done on the existence and formation of risk and issue based health policies, there is only little insight in health policy development processes in a broader context. This hampers intervention in these policy processes to adequately develop integrated and effective health policies. Legislation in the Netherlands requires municipalities to develop and implement local health policies. These policies are supposed to aim at the promotion of health across sectors and with a strong community involvement. Health policy development processes have been studied in four Dutch municipalities. For each case, we identified a range of stakeholders and monitored the change or stability of their characteristics over 3 years. In addition, for each case, three overlaying maps of networks were made addressing communication and collaboration actions within the defined set of stakeholders. We point out a number of barriers which impede integrated policy development at the local level: the importance given to local health policy, the medical approach to health development, the organizational self-interest rather than public health concern, the absence of policy entrepreneurial activity. Furthermore, this article advocates the use of complementary theoretical frameworks and the expansion of the methodological toolbox for health promotion. The value of stakeholder and network analysis in the health promotion domain, at this stage, is two-fold. First, mapping relevant actors, their positions and connections in networks provides us with insight into their capacity to participate and contribute to health policy development. Second, these new tools contribute to a further understanding of policy entrepreneurial roles to be taken up by health promotion professionals and health authorities in favour of the socio-environmental approach to health. Notwithstanding the value of this first step, more research is required into both the practical application as well as in the theoretical connections with, for example, Multiple Streams theory.

Background: In the Netherlands, managed competition between health plans has been introduced. For Dutch health plans this implies that they need to collect data about their own performance and that of the care providers they contract. To that end, Consumer Assessment of Health Plan Surveys (CAHPS) instruments have recently been adopted by a large Dutch health plan. Objectives: This paper presents the results of a validation study of the Dutch version of the CAHPS Adult Commercial questionnaire. The questions addressed are as follows: Can this questionnaire be adapted for use in the context of the Dutch insurance system? and Can it generate valid information about the quality of health care and the performance of Dutch health plans? Methods: The translated questionnaire has been mailed to a sample of 977 enrollees. The psychometric properties of the translated instrument have been studied, and the results have been compared with those of other Dutch and American studies. Results: The net response rate was 51% (n = 500). In general, the questionnaires were filled out completely and consistently. Principal component analyses revealed a factor that can be labelled as patient-centredness in the primary process. It contains the domains that in the CAHPS literature are described as ‘courteous/helpful staff’ and ‘doctors communicating well’. Conclusions: The translated version of the CAHPS Adult Commercial questionnaire is a promising tool for Dutch health plans. More research is needed on the external and the content validity of these questionnaires in the Dutch context.

Background: There is a growing awareness that there should be a public health perspective to health system governance. Its intrinsic population health orientation provides the ultimate ground for determining the health needs & governing collaborative care arrangements within which these needs can be met. Notwithstanding differences across countries, population health concerns are not central to European health reforms. Governments currently withdraw leaving governance roles to care providers &/or financiers. Thereby, incentives that trigger the uptake of a public health perspective are often ignored. Methods: In this study we addressed this issue in the city of Amsterdam. Using a qualitative study design, we explored whether there is a public health perspective to the governance practices of the municipality & the major sickness fund in Amsterdam, & if so, what the scope of this perspective is, & if not, why not. Results: Findings indicate that the municipality has a public health perspective to local health system governance, but its scope is limited. The municipality facilitates rather than governs health care provision in Amsterdam. Furthermore, the sickness fund runs major financial risks when adapting a public health perspective. It covers an insured population that partly overlaps the Amsterdam population. Returns on investments in population health are therefore uncertain, as competitors would also profit from the sickness fund's investments. Conclusion: The local health system in Amsterdam is not consistently aligned to the health needs of the Amsterdam population. The Amsterdam case is not unique & general consequences for local health system governance are discussed. Figures, Appendixes, References. Adapted from the source document.

Many countries have national health systems that cover all or part of the population. An aging population and advances in medical technology are making health insurance increasingly expensive, and governments are left seeking cost-effective options. The Dutch government is reorganizing its health care system and seeking to combine economic competition with a right to health in order to improve the health of its population. This article addresses privatization in terms of a right to health and asks whether governments can privatize their health care systems while also guaranteeing the availability, accessibility, acceptability, and quality of health care services. It is suggested that a \"right to health impact assessment\" can be a useful tool applicable also to the privatization processes in other countries. /// Beaucoup de pays ont mis en place des programmes nationaux de santé publique couvrant la totalité ou une partie de leur population. L'avancement de l'âge des populations et les progrès de la technologie médicale augmentent progressivement les coûts de l'assurance-maladie et les gouvernements sont forcés de trouver des options dont le rapport coût-efficacité est satisfaisant. Le gouvernement néerlandais est en train de réorganiser sa politique nationale de santé publique et cherche à intégrer les principes de la libre concurrence économique avec ceux du droit à la santé, afin d'améliorer la santé de sa population. Cet article traite de la privatisation en la rapprochant du droit à la santé et interroge les gouvernements sur leur capacité à privatiser la santé publique tout en garantissant la disponibilité, l'accès, l'acceptabilité et la qualité des services de santé. L'étude suggère qu'un \"droit à l'estimation de l'impact sur la santé\" peut s'avérer utile et susceptible d'être également appliqué aux processus de privatisation d'autres pays. /// Muchos países cuentan con sistemas nacionales de salud que cubren completa o parcialmente a la población. Una población que envejece y los avances en la tecnología médica están haciendo que los seguros médicos se vuelvan cada vez más caros, y los gobiernos se queden buscando opciones rentables. El gobierno holandés está reorganizando su sistema de atención médica y está buscando combinar la competencia económica con los derechos a la salud a fin de mejorar la salud de su población. En este artículo se habla de la privatización en términos de un derecho a la salud y se pregunta si los gobiernos pueden privatizar sus sistemas de atención médica mientras garantizan a la vez la disponibilidad, accesibilidad, aceptabilidad y calidad de los servicios de atención médica. Se sugiere que el \"derecho a una investigación sobre el impacto en la salud\" puede ser una herramienta útil aplicable también al proceso de privatización en otros países.

A study of recent legal developments and new research on Euthanasia, especially in regard to the Netherlands and Belgium, where it has been legal since 2002. Also included are short descriptions of the legal situations and what is known about actual practices in a number of other European countries, the UK, Switzerland, France, and Spain. The book covers the substantive law, the process of legal development that has led to the current state of the law, the system of legal control and its operation in practice, and the results of empirical research concerning actual medical practice of euthanasia.

Background This paper outlines the methodology, study population and response rate of a third large Dutch population-based cross-sectional serosurvey carried-out in 2016/2017, primarily aiming to obtain insight into age-specific seroprevalence of vaccine-preventable diseases to evaluate the National Immunization Programme (NIP). In addition, Caribbean Netherlands (CN) was included, which enables additional research into tropical pathogens. Methods A two-stage cluster sampling technique was used to draw a sample of Dutch residents (0–89 years) (NS), including an oversampling of non-Western migrants, persons living in low vaccination coverage (LVC) areas, and an extra sample of persons born in Suriname, Aruba and the former Dutch Antilles (SAN). A separate sample was drawn for each Caribbean island. At the consultation hours, questionnaires, blood samples, oro- and nasopharyngeal swabs, faeces, − and only in the Netherlands (NL) saliva and a diary about contact patterns – were obtained from participants. Vaccination- and medical history was retrieved, and in CN anthropometric measurements were taken. Results In total, blood samples and questionnaires were collected from 9415 persons: 5745 (14.4%) in the NS (including the non-Western migrants), 1354 (19.8%) in LVC areas, 501 (6.9%) SAN, and 1815 (23.4%) in CN. Conclusions This study will give insight into protection of the population against infectious diseases included in the NIP. Research based on this large biobank will contribute to public health (policy) in NL and CN, e.g., regarding outbreak management and emerging pathogens. Further, we will be able to extend our knowledge on infectious diseases and its changing dynamics by linking serological data to results from additional materials collected, environmental- and pharmacological data.

Purpose During the COVID-19 pandemic in the Netherlands, governmental regulations resulted in a lockdown for adults as well as children/adolescents. Schools were closed and contact with other people was limited. In this cross-sectional, population-based study, we aimed to investigate the mental/social health of children/adolescents during COVID-19 lockdown. Methods Two representative samples of Dutch children/adolescents (8–18 years) before COVID-19 (2018, N  = 2401) and during lockdown (April 2020, N  = 844) were compared on the Patient-Reported Outcomes Measurement Information System (PROMIS) domains: global health, peer relationships, anxiety, depressive symptoms, anger, sleep-related impairment by linear mixed models and calculating relative risks (RR (95% CI)) for the proportion of severe scores. Variables associated with worse mental/social health during COVID-19 were explored through multivariable regression models. The impact of COVID-19 regulations on the daily life of children was qualitatively analyzed. Results Participants reported worse PROMIS T -scores on all domains during COVID-19 lockdown compared to before (absolute mean difference range 2.1–7.1 (95% CI 1.3–7.9). During lockdown, more children reported severe Anxiety (RR = 1.95 (1.55–2.46) and Sleep-Related Impairment (RR = 1.89 (1.29–2.78) and fewer children reported poor Global Health (RR = 0.36 (0.20–0.65)). Associated factors with worse mental/social health were single-parent family, ≥ three children in the family, negative change in work situation of parents due to COVID-19 regulations, and a relative/friend infected with COVID-19. A large majority (> 90%) reported a negative impact of the COVID-19 regulations on daily life. Conclusion This study showed that governmental regulations regarding lockdown pose a serious mental/social health threat on children/adolescents that should be brought to the forefront of political decision-making and mental healthcare policy, intervention, and prevention.

The COVID-19 pandemic has disproportionately affected persons in long-term care, who often experience health disparities. To delineate the COVID-19 disease burden among persons with intellectual disabilities, we prospectively collected data from 36 care facilities for 3 pandemic waves during March 2020-May 2021. We included outcomes for 2,586 clients with PCR-confirmed SARS-CoV-2 infection, among whom 161 had severe illness and 99 died. During the first 2 pandemic waves, infection among persons with intellectual disabilities reflected patterns observed in the general population, but case-fatality rates for persons with intellectual disabilities were 3.5 times higher and were elevated among those >40 years of age. Severe outcomes were associated with older age, having Down syndrome, and having >1 concurrent condition. Our study highlights the disproportionate COVID-19 disease burden among persons with intellectual disabilities and the need for disability-inclusive research and policymaking to inform disease surveillance and public health policies for this population.

In A History of Plague in Java, 1911-1942 , Maurits Bastiaan Meerwijk demonstrates how the official response to the 1911 outbreak of plague in Malang led to one of the most invasive health interventions in Dutch colonial Indonesia. Eager to combat disease, Dutch physicians and officials integrated the traditional Javanese house into the \"rat-flea-man\" theory of transmission. Hollow bamboo frames and thatched roofs offered hiding spaces for rats, suggesting a material link between rat plague and human plague. Over the next thirty years, 1.6 million houses were renovated or rebuilt, millions more were subjected to periodic inspection, and countless Javanese were exposed to health messaging seeking to \"rat-proof\" their beliefs along with their houses. The transformation of houses, villages, and people was documented in hundreds of photographs and broadcast to overseas audiences as evidence of the \"ethical\" nature of colonial rule, proving so effective as propaganda that the rebuilding continued even as better alternatives, such as inoculation, became available. By systematically reshaping the built environment, the Dutch plague response dramatically expanded colonial oversight and influence in rural Java.