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Assisted dying for healthy older people: a step too far?

BMJ 2017; 357 doi: https://doi.org/10.1136/bmj.j2298 (Published 19 May 2017) Cite this as: BMJ 2017;357:j2298
  1. Els van Wijngaarden, researcher1,
  2. Ab Klink, professor2,
  3. Carlo Leget, professor1,
  4. Anne-Mei The, professor3
  1. 1University of Humanistic Studies, Utrecht, Netherlands
  2. 2VU University, Amsterdam, Netherlands
  3. 3University of Amsterdam, Amsterdam, Netherlands
  4. Correspondence to: E van Wijngaarden e.vanwijngaarden@uvh.nl

A recent Dutch proposal to extend its assisted dying law could increase social pressure on older people and reinforce negative ideas surrounding old age, argue Els van Wijngaarden and colleagues

In October 2016, the Dutch minister of health, welfare, and sports advanced a proposal to legalise assisted dying for older people who are considered healthy but believe their life is complete.1 Although the law allows assisted dying for people with incurable physical or mental health problems, there are currently no legal grounds for performing euthanasia in these cases because most people do not meet the required criteria (box 1).

Box 1: Legal requirements of due care to perform euthanasia in the Dutch context 2

  • The physician held the conviction that the request by the patient was voluntary and well considered

  • The patient’s suffering was lasting and unbearable

  • The physician had informed the patient about their situation and prospects

  • The physician agreed with the patient that there was no other reasonable solution

  • The physician consulted at least one other independent physician who saw the patient

  • The physician terminated the life or assisted in the suicide with due care

The minister underlined that current Dutch euthanasia practice is considered to be careful, safe, verifiable, and transparent and that there is a broad support of the law and practice among physicians and the general public.1 She cited recent independent research that the current euthanasia law functions properly,34 although some scholars have disputed this.5678

The guiding value in the proposed new law would be autonomy rather than compassion, which the proposal describes as “the ideal and right that each individual should be able to govern his or her life without interference of anyone else.” This shifts the focus from the role of physicians and their conflict of duties (preserving life versus alleviating intolerable and hopeless suffering) to the right …

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