Wim Distelmans

Wim Distelmans
Vrije Universiteit Brussel | VUB · Department of Supportive and Palliative Care

Doctor of Medicine

About

54
Publications
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Introduction

Publications

Publications (54)
Article
Full-text available
In 2015, the Belgian Federal Commission for the Control and Evaluation of Euthanasia referred a physician to the public prosecutor’s office because it concluded that the physician might have violated the legal conditions for euthanasia. It was the commission’s first referral since its establishment in 2002. However, in 2019, the Antwerp Court sitti...
Chapter
De Belgische euthanasiewet bestaat 20 jaar. Vanaf het begin deed ze veel stof opwaaien en was de redelijkheid in de discussies tussen voor-en tegenstanders soms ver zoek. Meer dan in de beginjaren ligt nu de mogelijkheid van euthanasie bij specifieke doelgroepen in het hart van de controverse. Het thema euthanasie bij psychisch lijden als gevolg va...
Article
Full-text available
Patients fulfilling criteria for euthanasia can choose to donate their organs after circulatory death [donors after euthanasia (DCD V)]. This study assesses the outcome of islet cell isolation from DCD V pancreases. A procedure for DCD V procurement provided 13 pancreases preserved in Institut Georges Lopez-1 preservation solution and following aci...
Article
Full-text available
Objective: In Belgium, people with an incurable psychiatric disorder can file a request for euthanasia claiming unbearable psychic suffering. For the request to be accepted, it has to meet stringent legal criteria. One of the requirements is that the patient possesses decision-making capacity. The patient's decision-making capacity is assessed by...
Article
To the Editor With initial amazement we read the recent Viewpoint of Shankaran et al.¹ The practice of “Big Pharma” to scam patients at one of the most vulnerable moments of their lives with excessive drug cost is far from dignified.
Chapter
Palliatieve zorg verbetert de levenskwaliteit van patiënten met een levensbedreigende aandoening en die van hun naasten. Het is méér dan terminale zorg en kan al vroeg, zelfs tijdens een ‘actieve behandeling’, ingezet worden. Men spreekt van ‘supportieve zorg’ wanneer deze parallel aan medische technologie wordt gegeven bij een (nog) niet terminale...
Article
Hoe is een klein landje als België erin geslaagd om zowel goed georganiseerde palliatieve zorg als de wettelijke mogelijkheid van euthanasie te voorzien? Zeker niet zonder slag of stoot. Zelfs vandaag wordt door sommige hardliners palliatieve zorg nog te graag uitgespeeld tegen euthanasie.
Article
Full-text available
To identify patterns in euthanasia requests and practices relating to psychiatric patients; to generate recommendations for future research. Retrospective analysis of data obtained through medical file review. Outpatient psychiatric clinical setting in the Dutch-speaking region of Belgium, between October 2007 and December 2011; follow-up at the en...
Article
Full-text available
Objective International research shows that oncology staff suffers more from burnout than other healthcare professionals. Burnout is common among oncologists. The prevalence of emotional exhaustion, depersonalization, and low personal accomplishment appears to be significantly higher among physicians. Detecting burnout is highly relevant, because i...
Article
Full-text available
This article analyses domestic and foreign reactions to a 2008 report in the British Medical Journal on the complementary and, as argued, synergistic relationship between palliative care and euthanasia in Belgium. The earliest initiators of palliative care in Belgium in the late 1970s held the view that access to proper palliative care was a precon...
Article
Full-text available
Background Following the 2002 enactment of the Belgian law on euthanasia, which requires the consultation of an independent second physician before proceeding with euthanasia, the Life End Information Forum (LEIF) was founded which provides specifically trained physicians who can act as mandatory consultants in euthanasia requests. This study asses...
Article
In only a few countries, such as Belgium and the Netherlands, and in some states in the United States, euthanasia/physician-assisted suicide (EAS) is legally possible under some circumstances. Arguments in favor of legalization of EAS are that it might function as a safeguard to semilegal practices, that it fosters transparency, and that it enables...
Article
To study the implementation of LEIF, the consultation service which provides access to specially trained physicians to act as the legally required second physician in requests for euthanasia in Flanders and Brussels, Belgium, the use of which has been to shown to be beneficial to the careful practice of euthanasia. A representative sample of 3006 B...
Article
Palliative care (PC) and legal euthanasia are widely considered as antagonistic societal developments and causes, originating in fundamentally different philosophies and conceptions of care. Pragmatically, the opponents of legal euthanasia fear: 1. "slippery slope" effects which would endanger vulnerable patients and 2. that legalisation would impe...
Article
This paper summarises the controversies concerning the pursuit of synergy between palliative care (PC) and euthanasia in Belgium. It purports to interpret and discuss these findings. Carrying out euthanasia is emotionally charged for some, while for others it is simply part of their career. Across nations, the physicians' willingness to practice eu...
Article
In Belgium and the Netherlands, consultation of a second independent physician by the attending physician is mandatory in euthanasia cases. In both countries, specialized consultation services have been established to provide physicians trained for that purpose. This retrospective study describes and compares the quality of consultation of both ser...
Article
To describe role and involvement of Life End Information Forum (LEIF) physicians in end-of-life care decisions and euthanasia in Flanders. All 132 LEIF physicians in Belgium received a questionnaire inquiring about their activities in the past year, and their end-of-life care training and experience. Response rate was 75 percent. Most respondents f...
Article
Full-text available
Screening instruments may enhance the clinician's ability to detect elevated levels of distress in cancer patients, but these are often neither suitable nor effective for the routine of daily care for cancer patients. The newly developed Distress Barometer (DB) was intended to provide medical doctors with a convenient tool to interpret 'at single g...
Article
Full-text available
Debates about euthanasia often polarise opinion, but Jan Bernheim and colleagues describe how in Belgium the two camps grew up side by side to mutual benefitAlthough palliative care and legalised euthanasia are both based on the medical and ethical values of patient autonomy and caregiver beneficence and non-maleficence,1 they are often viewed as a...
Article
Until now, in Belgium at least, no scientific information has been available about which patients are referred to multidisciplinary palliative home care teams (MHCT) and by which caregivers, nor about timing of referral and factors associated with it. A prospective cohort study was carried out during a nine-month period in the oldest Flemish MHCT,...
Article
The Federal Committee of Control and Evaluation regarding Euthanasia ("committee") was instituted according to the law on euthanasia. Sixteen members (and 16 deputy members) are on the committee, which consists of 8 physicians, 4 health providers and 4 lawyers. The main task of the committee is to evaluate if the registered cases of euthanasia (on...
Article
Full-text available
Despite international agreements and recommendations regarding cancer pain therapy, the effectiveness of pain treatment is still a major problem even in Western countries. Part of the problem is that physicians and nurses often lack knowledge of methods for the assessment and treatment of cancer pain and may have many rigid beliefs and attitudes. T...
Article
As pain is a sensation generated in the brain, the validity of the distinction that is often made between physical and psychic pain can be questioned. We postulate that the distinction is irrelevant for the person experiencing pain or grief. Both physical and psychic pain, as well as other causes, can lead to mental suffering. The medical professio...
Article
Docetaxel (taxotere; RP 56976) is twice as potent as taxol in the inhibition of microtubule depolymerisation and accumulates cells in their G2/M-phase, which is a highly sensitive phase of the cell cycle. The present study was designed to test the hypothesis that this property may lead to an enhanced effect of ionizing radiation on tumors. In a fir...
Article
Erbulozole (R55 104) is a water soluble congener of the microtubule inhibitor tubulozole, which has proven to possess anti-invasive, antitumoral and radiosensitizing capacities. A dose-finding study was performed on respectively 9 patients (every three weeks; doses ranging from 20 mg/m2 to 100 mg/m2; maximum 2 cycles per patient) and 6 patients (we...
Article
5'-nor-anhydrovinblastine (Navelbine®) is a hemisynthetic Vinca alkaloid for which a selectivity for mitotic microtubules has been demonstrated. In previous studies, we have demonstrated an anti-invasive effect of other Vinca alkaloids. Here the results of in vitro and in vivo assays concerning the effect of 5'-nor-anhydrovinblastine on growth and...
Article
Full-text available
In search for clues to the potential immunomodulating mechanism of action of levamisole which might be used as monitoring parameters, we have determined a variety of cytokines in the peripheral blood of volunteers and carcinoma patients before and after a single or a 3-day-treatment with 150 mg/day. In cancer patients no changes could be detected 4...
Article
Fragments of human colorectal adenocarcinomas were inserted under the renal capsule of nude mice. The growth of these tumour grafts was significantly inhibited by the combination of 5-fluorouracil (5-FU) and levamisole. An alternating regimen of levamisole 2.5 mg/kg and 5-FU 20 mg/kg decreased the size of tumour implants by 33-59% and/or increased...
Article
The clinically applicable formulation of the microtubule inhibitor erbulozole (R 55 104), dissolved into an aqueous hydroxypropyl-beta-cyclodextrin solution (designated as R 55 104-CYCLO), exerts a similar effect on growth delay of subcutaneous MO4 fibrosarcomas in mice, with or without 10 Gy gamma-irradiation given locally to the tumors 2 h later,...
Article
The antitumoral activity of a novel imidazole derivative, R 75251, has been studied in the androgen-dependent R3327G Dunning prostate adenocarcinoma grafted subcutaneously in syngeneic rats. Dietary application resulting approximately in dose levels of 80, 120, and 160 mg/kg reduced tumor weight by 66, 81, and 79%, respectively. This effect was not...
Article
Erbulozole (P.I.N.N.) (R 55 104) is a more water soluble congener of the synthetic microtubule inhibitor tubulozole (R 46 846) exhibiting a reversible antimicrotubular activity in vitro at a dose (1.56 x 10(-8) M) which is at least 10-fold lower. The compound also has an antiinvasive potential and shows antitumoral effects both in vitro and in vivo...
Article
The combined effect of the microtubule inhibitor tubulozole and gamma-irradiation has been investigated in vivo in subcutaneous MO4 fibrosarcomas and Lewis Lung carcinomas. A marked interactive effect on tumor growth was observed when 160 mg/kg tubulozole was orally administered before the tumors were treated with 10 Gy radiation. Dose dependency a...
Article
We have implanted MO4 transformed mouse cells attached to a collagen matrix (artificial tumor) under the renal capsule of syngeneic mice. It was our purpose to evaluate whether or not the kidney invasion test (KIT) could be used for the determination in vivo of the invasive capacity of cultured cell populations. Invasion was expressed in terms of t...
Article
Implantation of fragments from subcutaneously grown Lewis lung carcinoma 3LL under the renal capsule of syngeneic mice results in invasion of the kidney parenchyma. The synthetic microtubule inhibitor tubulozole blocks or decreases this malignant invasion in a dose-dependent manner. The inhibition of the invasion rate caused by tubulozole can be ma...
Article
Four phenotypes of a sex-linked, maternally influenced semi-lethal eye color mutant of Glossina morsitans morsitans Westwood were fed on Trypanosoma congolense Broden infected guinea pigs. Infection rates were evaluated 25 days later by means of dissection. Procyclic as well as mature infections were significantly more common among females with sal...
Article
When MO4 tumor fragments were implanted under the renal capsule of syngeneic or allogeneic mice, invasion of the renal parenchyma was observed. Inhibition of invasion by the microtubule inhibitor tubulozole could be macroscopically quantified and compared with the invasion permissive drug etoposide (VP-16-213). These results have been histologicall...
Article
Since the early nineties, palliative care has been implemented in Belgium. Until recently, its development is mainly based on palliative home care as well as hospice care (i.e. residential units) and support teams in hospitals (Rombouts, 1999).

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