Both the Kingston University Research Ethics Committee (London, UK) and the Legal Council of University Hospital Maastricht (Netherlands) confirmed that our study was exempt from ethical review, so no informed consent was required. We used anonymized data that are publicly available on the RTE website. The content of the RTE website is subject to a Creative Commons Zero (CC0) declaration, which means that re-use is permitted (https://www.euthanasiecommissie.nl/copyright).9 The RTE states that they select anonymized cases for publication, based on their relevance to the development of standards and their importance in terms of public and societal interest.9 We discussed our study with a lawyer who is responsible for ethical issues involved in the use of the RTE database. They highlighted that a committee appointed by the Dutch government, which oversees ethical issues around use of the database, has recommended that the published data may be used on commented on freely and without need for further ethical approvals, as long as they are not combined with any other data sets (such as death records) that might compromise anonymity. Our study protocol involved scrutiny of the publicly available data only, and therefore, the lawyer confirmed that as these have already been subject to Dutch government considerations, further ethical approvals were not required.