Perspectives on Euthanasia in the Netherlands

In the Netherlands the art and control of euthanasia and assisted suicide has gained significant concern. This practice is being used as a point in discussions beyond Netherlands and also in the Netherlands; hence, a clear explanation of the situation there is necessary. One of the key questions about euthanasia is that if there are adequate precautions available. In addition, this type of the ‘slippery slope’ theory has been the main powerful justification against legalizing euthanasia in pluralistic societies.

In this country, the word has a more narrow meaning; it corresponds just to another person’s intentional ending of a person’s life upon his demand (i.e., active, voluntary euthanasia). And hence the prevention of discomfort, by heavy doses of morphine, with the adverse effect of reducing the life expectancy, is not called euthanasia. This statement deals in the specific sense with the control and practice of euthanasia. It is also in this context that euthanasia has received so much publicity and much debate in this country.

There is one case that culminated in the Supreme Court’s landmark ruling in 1984. This case is recognised as the Alkmaar case involving a woman aged 95 who was severely ill with little possibility of survival. She experienced significant decline in health the weekend prior to her demise. She became incapable of eating or drinking and lost consciousness. She also repeatedly begged to her physician to relieve her pain. She stated, upon restoring consciousness, that she didn’t need to go through such an encounter again, and begged her doctor to take her life. Eventually, as he was reassured that each and every day would only be a terrible burden on the sufferer, the doctor agreed to act as per her desires.

Physicians on trial for assisted dying have justified themselves in various instances. The only plea for acquittal which was not dismissed, and which was also accepted by the Supreme Court in 1984, is the invocation of a situation of ‘force majeure’ (or necessity), resulting from a conflict of duties: the duty towards the patient to alleviate hopeless suffering and the duty towards the law to preserve the patient’s life. A practitioner would not be punished considering the specific circumstances of the scenario; he or she has properly assessed the competing roles and reached a conclusion which can be reasonably explained. The case had been appealed to The Hague Court that discharged the defendant.

That year only the Royal Dutch Medical Association (K.N.M.G.) issued guidelines in this context for its members. During that time the physicians deliberately reduced the lifespan of a lot of Dutch people. Thus accepting the possibility that there will never be unity in a pluralistic culture on topics like medical termination of pregnancy and euthanasia, even within physicians, the health agency claimed that under some cases euthanasia could be reasonable. To advise the professionals on the circumstances whereby euthanasia might be lawful, it devised a set of guidelines that constitute the requirements established by the judiciary:

  • The petition for euthanasia must come from the individual and be completely voluntary, well contemplated and permanent
  • Patients must undergo unimaginable pain (physical or mental), and little possibility of recovery and with no suitable remedies to relieve the condition of the sufferer
  • Euthanasia must be conducted by a practitioner after consulting an impartial expert with expertise in this sector.

Advances in science and medicine have prompted a transition in the norm on the sacredness of life in this country and elsewhere. Because life is often viewed as something very valuable, it has evolved to be known that regard for life may not be infinite. In this country, as debates arose over who all would take part in the determination whether or not to interrupt medication, or whether or not to alleviate pain with a potential life-shortening impact, it was evident that clinical factors alone could not decide the problem.

Thoughts on standards of living were component of the discourse. Consequently the perspective of the patient became more relevant. In this manner, self-determination was paired with second-party supervision dependent on the doctor’s moral ethics. The magnitude of second-party mechanism in this country is shown by the high number of doctors recording end-of-life judgment-making consultations with sufferers with respect to second-party euthanasia control is a mandatory requirement, else end-of-life is not an alternative.

A lack of medical care services does not intensify the Dutch tradition of assisted suicide. Most these deaths occur at residence in patients with a life expectancy of less than a month after hospital care seems inadequate. Here, the pattern is not downhill rather uphill. This can be inferred from the significant growth in recorded cases; expanded understanding of the conditions of euthanasia cases; and recognition of the presence of end-of-life cases lacking a clear appeal, and hence the likelihood of resolving this problem and reducing this segment by protecting the wishes of patients before they are incapable (for example, by the use of living wills).