Feature Briefing

Assisted dying: law and practice around the world

BMJ 2015; 351 doi: https://doi.org/10.1136/bmj.h4481 (Published 19 August 2015) Cite this as: BMJ 2015;351:h4481
  1. Owen Dyer1,
  2. Caroline White2,
  3. Aser García Rada3
  1. 1Montreal
  2. 2London
  3. 3Madrid
  1. Correspondence to: C White (Europe) cwhite{at}bmj.com; O Dyer (North America) owen_dyer{at}hotmail.com; A García Rada (South America) alphaborealis{at}hotmail.com

Several countries in Europe and in North and South America already allow doctors to help patients end their lives. Caroline White, Owen Dyer, and Aser García Rada report

The Netherlands

Voluntary euthanasia and assisted suicide (see box for definitions) remain a crime here, but, since 2002, doctors who end a life on request or who help a patient die can no longer be prosecuted, provided that they have met the statutory “due care” criteria. These include that the request is voluntary; the patient’s physical or mental suffering is unbearable with no prospect of improvement; the patient is fully informed about the prognosis; and doctor and patient have jointly concluded that no other reasonable solution exists.

At least one other doctor must be consulted and must state in writing that due care was fully discharged. The Royal Dutch Medical Association has set up a network of independent medical assessors for this purpose. The attending doctor must also report the death to the appropriate regional euthanasia review committee. In theory, non-residents can ask for help in ending their life, but the law requires a close doctor-patient relationship.

People with dementia are eligible, as are mentally competent minors (aged 12 to 17), but only if an advance directive has been made. The parents or guardians must also agree in cases of 12 to 15 year olds, and parents must be involved in discussions in cases of 16 to 17 year olds. Under the Groningen Protocol (2005) doctors can end the lives of newborns in specific circumstances.

Reported cases of assisted suicide/euthanasia totalled 4829 in 2013, up from 2636 in 2009.1 Some 78.5% of assisted deaths have occurred at home, 9% in nursing or care homes, and 6% in hospices. In five cases from the most recent year the doctor was judged not …

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