Education And Debate

Euthanasia in the Netherlands

BMJ 1994; 308 doi: (Published 21 May 1994) Cite this as: BMJ 1994;308:1346
  1. Gerrit van der Wal, medical inspector Royal Dutch Medical Associationa,
  2. Robert J M Dillmann, secretary of medical affairs+a
  1. a PO Box 20051, 3502 LB Utrecht, Netherlands
  2. aMedical Inspectorate of Health for the Province of North-Holland, PO Box 3125, 2001 DC Haarlem, Netherlands
  1. Correspondence to: Dr Dillmann.
  • Accepted 14 April 1994

The practice of euthanasia in the Netherlands is often used as an argument in debates outside the Netherlands--hence a clear description of the Dutch situation is important. This article summarises recent data and discusses conceptual issues and relevant characteristics of the system of health care. Special emphasis is put on regulation, including relevant data on notification and prosecution. Besides the practice of euthanasia the Dutch are confronted with the gaps in reporting of cases to the public prosecutor and the existence of cases of ending a life without an explicit request. Nevertheless, the “Dutch experiment” need not inevitably lead down the slippery slope because of the visibility and openness of this part of medical practice. This will lead to increased awareness, more safeguards, and improvement of medical decisions concerning the end of life.


The practice and regulation of euthanasia and assisted suicide in the Netherlands has attracted much attention. Opponents feel that the practice of euthanasia in the Netherlands must be presented as a deterrent to euthanasia elsewhere,*RF 1-6* but others view the situation in the Netherlands as an important development suggesting changes within their own countries or states.*RF 7-12* Since trustworthy empirical data have not been available until recently, moral viewpoints have coloured the estimated numbers of cases of euthanasia (and assisted suicide) and the way in which it is practised. Recent reports, however, have diminished this empirical uncertainty.*RF 13-18*

One of the main concerns with regard to euthanasia is whether sufficient safeguards are possible. In turn, in pluralistic societies this form of the “slippery slope” argument is the most important argument against legalisation of euthanasia.19,20 This article describes the situation in the Netherlands, with special emphasis on regulation, including relevant data on notification and prosecution.

Conceptual issues

Particular conceptual demarcations with regard to euthanasia and other medical …

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