Physician Assisted Suicide (PAS)

In Holland - the Netherlands

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Summary:

Physician assisted suicide is legal in the Netherlands, but must be done under strict rules.

About 3% of all deaths in the country are reported as involving physician assistance. The actual number is believed to be higher. According to a statement by Dr. Keith Wilson of the Ottawa Health Research Institute in 2007, between 6 and 10% of Dutch patients with advanced cancer choose to die this way. ₁

Public opinion remains very heavily in favor of continuing the present system.

Some recent developments:

1993: Euthanasia was theoretically illegal in this country and remains so today. However, a law was passed in 1993 which prevents doctors from being prosecuted for euthanasia if:

	the patient is in intolerable pain (including emotional pain),
	the patient has repeatedly and lucidly asked to die,
	two doctors agree on the procedure,
	relatives are consulted, and
	the death is reported.

1998: In a 1998 public poll, 92% of Dutch adults supported access to physician assisted suicide.

1999: Physicians had complained that the government guidelines left them in a legal limbo. On 1999-JUL-12, the Dutch government announced the introduction of a bill to decriminalize physician assisted suicide. Wijnand Stevens, a spokesperson for the justice ministry said: "It was agreed that to decriminalize euthanasia is the logical [next] step of the policy we have had so far." ₂Assistance in dying would only be permitted only if:

	The patient must be suffering unbearably. However, they need not be terminally ill.
	The patient must make a request on a voluntary, well considered and sustained basis.
	The doctor and patient must have had a long-term relationship.
	There must be no reasonable alternative to relieve the patient's suffering.
	The doctor must consult at least one other independent physician.
	Due medical care must be followed,

The Voluntary Euthanasia Society (NVVE) and Royal Dutch Medical Association (KNMG) welcomed the bill.

2000: All three parties of the ruling coalition backed the bill during debate on 2000-NOV-23. Political opposition came from the Christian Democrats and some small Calvinist religious parties. A spokesperson for the conservative Protestant State Reformed Party commented that the Dutch government is "mopping up the last remaining scraps of Christian morals from the law books." They control two seats in parliament. Bert Dorenbos, spokesperson for the pro-life group Cry for Life, said: "You'll never know if doctors are coming to cure you or kill you." (He was apparently unaware of the act's provisions that the patient must first make repeated requests for assistance).

The bill was passed 104 to 40 in the lower chamber of parliament. ₃Derek Humphry, founder of the Hemlock Society in the U.S. said that the absence of an enabling law in America has driven the practice of assisted suicide underground. "It's going on underground extensively, but we would rather see it above ground and open and supervised by a team of people...Every day, there are dozens of cases in North America." Rev. Joaquin Navarro-Valls, a Vatican spokesperson said that the Dutch bill "violates the dignity of human beings... and goes against the natural law of individual conscience."₃

2002: On 2002-DEC-24, the highest court in the Netherlands ruled on a case involving a physician, Philip Sutorius, who had helped former senator, Edward Brongersma, to commit suicide in 1998. Brongersma had suffered from incontinence, dizziness and immobility. He said he was tired of life. Under Dutch law, a patient must face a future of intolerable suffering before he can request mercy killing. The highest court in the Netherlands ruled: "The question in this case was whether euthanasia is justified also in circumstances where a patient is tired of life." They concluded that the euthanasia law had not been intended for such situations, unless the patient is also in intolerable pain. The Dutch Medical Federation (KNMG) said there had been a great deal of debate in the Netherlands about cases in which patients were tired of life, and simply wanted to die. Their statement read, in part: "In practice, this is a gray area and in many cases it its not clear into which category a euthanasia request should be classified." They concluded that the court's decision had not clarified that point. ₃

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References used:

The following information sources were used to prepare and update the above essay. The hyperlinks are not necessarily still active today.

Anne-Marie Tobin, "Terminal patients favour ending life," The Toronto Star, 2007-JUN-08, Page L7.
"Dutch to legalize mercy killing." Associated Press, 1999-JUL-12.
"Guilty verdict upheld in Dutch euthanasia case," Reuters, 2002-DEC-24, at: http://www.alertnet.org/thenews/

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