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Dutch Experience
- John R Williamson (27 September 2005)
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U.N Human Rights Committee Concern over Dutch Regulation of Assisted Dying
- Claire A Stark Toller (28 September 2005)
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Dutch non-voluntary euthanasia figures
- Helen P Watt (29 September 2005)
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John R Williamson, GP Skegby NG17 3EE
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Holland has always quoted as the example of how to do euthanasia. However the Remmelink report in 1991 concluded that involuntary euthanasia was rife, even down to under 16 year olds. It also concluded that causes of death were falsified to cover the true figures. The article above accepts that there has been little improvement in reporting since the report was produced. Holland demonstates that euthanasia once introduced is expanded to cover those society finds inconvenient. It is following the same pattern as previous decades where ultimately those deemed to be unproductive are removed. Indeed there is already talk of offering this to those who are felt to be a burden on society by Politicians. If one visits the Hadamar Psychiatric Hospital, which was used for the German Euthanasia program, it is possible to peruse the documents written at the time by the administrators, and the Doctors who actually used the Gas Chambers there. The striking thing is that they are using exactly the same language and arguments about 'lives not worth living', and the management of those unfortunates, to those being offered today by the Pro-euthanasia lobby. Bearing in mind that 50% health Care costs occur in the last six months of life, isn't this a huge temptation for a cash strapped health care system, where palliative care is patchy and costly? In a culture where targets are king, can we see this not coming to pass. Competing interests: None declared |
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Claire A Stark Toller, SpR Palliative Care Oxford Deanery OX3 7LJ
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Editor – Onwuteaka-Philipsen et al state that only an estimated 54% of cases of assisted dying are reported in the Netherlands.[1] Discussing euthanasia and assisted suicide in the Netherlands, the United Nations Human Rights Committee “learnt with unease that under the present legal system more than 2,000 cases of euthanasia and assisted suicide (or a combination of both) were reported to the review committee in the year 2000 and that the review committee came to a negative assessment in only three cases. The large numbers involved raise doubts whether the present system is only being used in extreme cases in which all the substantive conditions are scrupulously maintained.”[2] I share the concerns of the United Nations Human Rights Committee that the current control and safeguard systems in the Netherlands have been and remain insufficient, making the abuse of assisted dying in the Netherlands a very real possibility. I would therefore suggest that assisted dying should remain illegal in the U.K. so that similar errors do not have the opportunity to occur here. Claire Stark Toller
1. Onwuteaka-Philipsen BD, van der Heide A, Muller MT, Rurup M, Rietjens JAC et al. Dutch experience of monitoring euthanasia. BMJ 2005;331:691-93 2. U.N. International Covenant on Civil and Political Rights, Human Rights Committee, Concluding Observations Netherlands, 27 August 2001, CCPR/CO/72/NET http://www.unhcr.ch/tbs/doc.nsf/0/dbab71d01e02db11c1256a950041d732?Opendocument Competing interests: None declared |
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Helen P Watt, Director Linacre Centre for Healthcare Ethics NW8 9NH
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If we want to know where Lord Joffe’s Bill might lead, we need only look across the North Sea. The Netherlands has a decades-long experience of euthanasia, and the results are such as to strike alarm into any reasonable observer. According to the second of three government-ordered studies, 900 patients were deliberately and actively killed without their request in 1995.[1]This figure does not include 1,537 cases where palliative drugs were given with the explicit, unrequested aim of hastening death.[2] If we include this group, more than a third of those actively killed were killed non-voluntarily. Even excluding this group of cases, one in five of those actively killed were killed without request – to say nothing of those deliberately killed by means of an omission. Unfortunately the 2001 data make it impossible to determine the exact level of non-voluntary active killing, since doctors who gave palliative drugs with the aim of hastening death were not asked if the patient had consented. What we do know is that, aside from this, 980 patients in 2001 were actively killed without their request.[3] It is all too clear where the concept of ‘lives unworthy of life’ has in practice led.[4] [1] Van der Wal VG, van der Maas PJ. Euthanasie en andere medische beslissingen rond het levenseinde: De Praktijk en de Meldingsprocedure [Euthanasia and Other Medical Decisions Concerning the End of Life: The Practice and the Notification Procedure]. The Hague, 1996. This and the previous government-ordered study are analysed in Keown J. Euthanasia, Ethics and Public Policy. Cambridge: Cambridge University Press, 2002: 81-149. [2] Van der Maas PJ et al. Euthanasia, physician-assisted suicide, and other medical practices involving the end of life in the Netherlands. N Engl J Med 1996; 355: 1704. [3] Van der Wal G, van der Maas PJ, Onwuteaka-Philipsen BD, van der Heide A. Medical decision-making at the end of life. The practice and the euthanasia notification procedure [in Dutch}. The Hague: Sdu Publishers, 2003: 67, Table 7.1. See also Fenigsen R. Dutch euthanasia: the new Government-ordered study. Issues in Law and Medicine 2004; 20: 73-79. [4] See e.g. Gormally L. Euthanasia, Clinical Practice and the Law. London: Linacre Centre, 1994; Finnis J. Euthanasia, Morality, and the Law. Loyola University of Los Angeles Law Review 1998; 31: 1123-45; Linacre Centre for Healthcare Ethics. Submission to the House of Lords Select Committee on the Assisted Dying for the Terminally Ill Bill, available online at http://www.linacre.org/AssistedDyingBillSub.htm. Competing interests: None declared |
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