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Netherlands gives more protection to doctors in euthanasia cases

Tony Sheldon, Utrecht

Dutch MPs have ended decades of uncertainty for the medical profession by voting to enshrine in law the exemption from criminal prosecution for doctors performing euthanasia within strict criteria.

The Ministry of Justice maintains that the bill does not amount to the legalisation of euthanasia but to "decriminalisation in certain circumstances." If the bill is approved by the senate then the Netherlands will become the first country in the world to legislate on mercy killing.

A doctor currently performing euthanasia must first report what remains a criminal act to regional review committees of doctors and lawyers. These committees advise the public prosecution service, which only then drops the case if the doctor is judged to have followed the specific criteria established through case law.

The new bill allows doctors' actions "not to be treated as a criminal offence" if the criteria are followed. The regional committees will now be able to dismiss the case. The public prosecution service could still launch its own criminal investigation. Doctors have spoken of the "psychological significance" of "no longer being guilty until proved innocent."

The Royal Dutch Medical Association (KNMG) welcomed the vote. It has long argued for ending the "paradoxical legal situation" that doctors acting within strict criteria could still face criminal prosecution.

Politicians hope that the new legal clarity will boost rates of reporting. Currently, less than 50% of an estimated 3600 cases of euthanasia a year are reported. The health minister, Els Borst, emphasised "openness," saying that the "issue should not be left in the dark."

The new bill also slightly redefines the criteria. Doctors must be "convinced" that the patient's request is voluntary and well considered and that the patient is facing "unremitting and unbearable" suffering; have advised the patient of his or her situation and prospects; and have reached a firm conclusion with the patient that there is "no reasonable alternative." At least one other independent physician must have examined the patient.

It also ensures that parental consent will now be required before incurably sick minors aged 12 to 16 can request euthanasia.

Both Protestant and Catholic communities fear that choosing to die will become a "normal" practice. But the Dutch medical association believes that the Netherlands benefits from the possibility that patients can request euthanasia from doctors "in situations of hopeless and unbearable suffering."

The justice minister, Benk Korthals, emphasised that doctors must be convinced of the "objective medical reasons" for the patient's suffering. Being merely "tired of life" was not sufficient.

(Credit: AP/SERGE LIGTENBERG) Dutch Justice Minister Benk Kortals and Health Minister Els Borst