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Physician Assisted Suicide (PAS)

In Holland - the Netherlands

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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 seek help via PAS rather than allow nature to take its course. 1

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

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Some recent developments:

bullet1993: 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:
bulletthe patient is in intolerable pain (including emotional pain),
bulletthe patient has repeatedly and lucidly asked to die,
bullettwo doctors agree on the procedure, 
bulletrelatives are consulted, and
bulletthe death is reported.
bullet1998: In a 1998 public poll, 92% of Dutch adults supported access to physician assisted suicide.
bullet1999: 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.2 Assistance in dying would only be permitted only if:
bulletThe patient must be suffering unbearably. However, they need not be terminally ill.
bulletThe patient must make a request on a voluntary, well considered and sustained basis.
bulletThe doctor and patient must have had a long-term relationship.
bulletThere must be no reasonable alternative to relieve the patient's suffering.
bulletThe doctor must consult at least one other independent physician.
bulletDue medical care must be followed,

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

bullet2000: 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. 3 Derek 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 DEC-24, the highest court in the Netherlands ruled on a case involving a physician, Philip Sutorius, who had helped former senator, Edward Brongersma, 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


2019: Misinformation about the suicide death of Noa Pothoven, 17: She had written a award winning memoir titled "Winning or Learning," about her experience with sexual assault, rape, post-traumatic stress disorder, depression, and anorexis.

At the age of 16, she went to the Levenseinde (end-of-life) clinic to inquire about physician assisted suicide. She was told that she was not eligible under Dutch law.

In late May, she posted a message on Instagram, saying that:

"After years of fighting, the fighting has finished. I have now stopped eating and drinking for a while, and after many conversations and reviews it has been decided that I will be released because my suffering is unbearable. I have not really been alive for so long, I am surviving, and not even that. I am still breathing but I am no longer alive."

She died on JUN-02 in a hospital bed in her family's home.

Her death triggered outrage in the media as people asked why she was allowed to die.

Her parents, the Levenseinde clinic, the Royal Dutch Medical Association and the Dutch health minister all emphasized that she did not die by euthanasia. Her family issued a statement saying:

"Noa had chosen not to eat and drink anymore. We would like to emphasize that this was the cause of her death. She died in our presence last Sunday. We kindly ask everyone to respect our privacy so we as a family can mourn."

However, media outlets generally said that she had been euthanized.

Naomi O'Leary, reporting for Politico Europe was one of the first English-language jouralists to get the facts of Noa's death straight. She tweeted on JUN-05:

"A 17-year-old rape victim was NOT euthanised in the Netherlands.@euronews @Independent @DailyMailUK @dailybeast are all wrong. It took me about 10 mins to check with the reporter who wrote the original Dutch story. Noa Pothoven asked for euthanasia and was refused.

Dyck Bosscher, a spokesman for the Dutch Voluntary Termination of Life Association (NVVE), which established the Levenseinde clinic, said:

"There is a lot of misunderstanding about our legislation around euthanasia. The media reports make it seem as if it is easy to get euthanasia in the Netherlands, but it's not the truth."

Eliza Mackintosh, writing for CNN, said:

"Bosscher explained that gaining approval was a complex, lengthy process under the criteria set out by Dutch law. Over the course of multiple interviews, those seeking euthanasia must convince a doctor that their request is voluntary, they are suffering unbearably, have exhausted all alternative options and are capable of understanding the weight of their decision, he said.

And, in cases like Pothoven's, when the patient is living with mental illness, the application is even more difficult, because the burden of proof is so high.

Of the patients who are approved to receive euthanasia by the Levenseinde clinic, only 9% are psychiatric patients. The rest are living with cancer or another disease." 4


2020-APR: The Dutch Supreme Court issued a ruling in a case in which a woman had earlier expressed -- in writing -- the desire to have medical aid in dying if her health declined to a specified degree. Later, her doctor decided that she had reached this point. However, she was no longer considered competent to verify her earlier written decision. In the past, a person always had to verify their earlier written decision before beng allowed access to MAID.

The court ruled that, from now on:

"A doctor can carry out an (earlier) written request for euthanasia from people with advanced dementia. 5

 The case involved some controversy, because it is alleged that the woman resisted the doctor's needle injection that eventually killed her.


2020-JUL: Pia Dijkstra, of the D66 progressive “social-liberal” party, has introduced a bill in the Second Chamber of the Dutch parliament  to allow legal assisted suicide for persons over 75 years of age who are simply "tired of living." It has little chance of becoming law.

If it were to pass, then persons seeking an end to their life would not have to prove unbearable suffering, lack of available treatment, no chance of improvement of their condition, etc. 6

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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.

  1. Anne-Marie Tobin, "Terminal patients favour ending life," The Toronto Star, 2007-JUN-08, Page L7.
  2. "Dutch to legalize mercy killing." Associated Press, 1999-JUL-12.
  3. "Guilty verdict upheld in Dutch euthanasia case," Reuters, 2002-DEC-24, at: http://www.alertnet.org/thenews/
  4. Eliza Mackintosh, "Misinformation swirling around Dutch teenager's death ignites debate over euthanasia," CNN, 2019-JUN-08, at: https://www.cnn.com/
  5. Wesley J. Smith, "Dutch Supreme Court uses forced euthanasia case to expand permission to kill patients," Life Site, 2020-APR-22, at: https://www.lifesitenews.com/
  6. "Netherlands contemplates expanding assisted suicide for people over 75 ‘tired of living’," LifeSite, 2020-JUL-27, at:

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Copyright © 1997 to 2020 by Ontario Consultants on Religious Tolerance
Latest update: 2020-JUL-27
Author: B.A. Robinson

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