Intended for healthcare professionals


Euthanasia: where the Netherlands leads will the world follow?

BMJ 2001; 322 doi: (Published 09 June 2001) Cite this as: BMJ 2001;322:1376

No. Legalisation is a diversion from improving care for the dying

  1. Ezekiel J Emanuel (, director
  1. Department of Clinical Bioethics, Warren G Magnuson Clinical Center, National Institutes of Health, Bethesda, MA 20892, USA

    Euthanasia and, to a much lesser extent, physician assisted suicide have been socially accepted and openly practised in the Netherlands for about two decades. The Netherlands' recent legalisation of euthanasia1 merely codifies what already exists and is unlikely to change Dutch practices significantly. The one exception may be to permit a few more cases of euthanasia among children aged 12–18 years. But drawn out deaths in this age group, predominantly from cancer or AIDS, are rare, accounting for fewer than 400 deaths (<0.2% of all deaths) a year in all of the Netherlands. The key question is not whether things will change in the Netherlands, but whether legalisation of euthanasia and physician assisted suicide there will stimulate a trend in other developed countries.

    This seems highly unlikely. Certainly in the United States, no state other than Oregon seems poised to take the opportunity presented by the 1997 Supreme Court ruling to legalise euthanasia or physician assisted suicide. Indeed, in the past five years 10 states have passed bills making euthanasia or physician assisted suicide illegal, …

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