Euthanasia: What Happened in the Netherlands
The Netherlands are often cited as a success case for Euthanasia, a place where Euthanasia has been legalized and is virtually abuse and problem free. The evidence suggests a different story with high rates of people being Euthanized without their consent and an increasingly large part of society dying from Euthanasia.
The History
During the 1970s, the Netherlands saw a small number of prosecutions for euthanasia, resulting in convictions, but minimal sentencing, with sentences ranging from 6 to 18 months. In 1984, after a case where a 93 year old woman was voluntarily euthanized, the Dutch Supreme Court justified the doctor on the basis of the doctor’s judgment about his patient’s quality of life.
Later, in 1994, the Dutch Supreme court again took up euthanasia, ruling that it could be justified on grounds of “necessity” as long as the patient were in either physical or psychological suffering.
In 2001, the Dutch Parliament approved a law allowing assisted suicide and euthanasia in a wide range of circumstances. The illness need not be terminal nor the suffering physical. The doctor need only believe that the patient is in some sort of suffering.
The 2001 act also allowed children as young as 12 to be euthanized so long as the child requested it and the parent’s consented, while children 16-17 do not need the consent of the parents (though parent’s should be ”involved.”
Safe, Legal, Rare?: How Many Die from Euthanasia?
Contrary to common claims, Euthanasia and physician assisted suicide are not “safe, legal, and rare.” They are prevalent and seem only to increase over time. Three Dutch surveys, from 1990, 1995, and 2001, are the source for information on assisted suicide and euthanasia in the Netherlands.
The 1990 survey found that 1.9% of all Dutch deaths were due to euthanasia. Another 0.3% were due to physician assisted suicide.
The 1995 survey found increases in both these numbers with 2.3% of deaths (a 27% increase) resulting from euthanasia and 0.4% of deaths from assisted suicide (a 40% increase).
By 2001, the euthanasia rate increased to 2.6%.
In 2016, 4% of all deaths were due to euthanasia (6,091).
Far from being “safe. legal, and rare, euthanasia in the Netherlands in common and, for the most part, increasing.
High Rates of Involuntary Euthanasia
1995 government surveys showed large numbers of people being euthanized without their consent. In 1995, 0.7% of all deaths (ca. 950), were people euthanized without giving consent. This same rate continued in the year 2001. At the time it seemed that between 20-25% of all euthanasia cases were non-consensual despite this being against Dutch Law.
A 1995 New York State Task Force appointed by Governor Mario Cuomo recommended against legalized assisted suicide estimating (based on the Dutch example) of 16,000 people being euthanized every year without their consent.
The numbers are probably higher because they only include active cases of killing the patient, they do not include the numerous cases when care was withdrawn or withheld with the express purpose of causing the patient’s death, again, without the patient’s consent. In 1990, there were almost 9,000 cases of care being withheld or withdrawn with the purpose of causing the patient’s death without his/her consent.
Poor Palliative Care
According to Gorsuch, some studies suggest that some Dutch physicians are not well trained in palliative care techniques. A 1990 study found that palliative care was inadequate in over 50% of cancer patients.
Why People Are Euthanized?
One of the claims of euthanasia and physician assisted suicide supporters is that they are only used in extreme cases to prevent extreme suffering. Yet, physicians surveyed claimed that this only motivated them in 18.8% of cases. Most of the time, they gave other reasons including: low prospect of improvement (60%), avoidance of “needless prolongation” (33%), relatives inability to cope (32%), patient’s low quality of life (31%).
Conclusions
The Dutch experience does not suggest that euthanasia, when legalized, becomes safe, legal, and rare, only used in extreme cases. Rather, euthanasia becomes increasingly common and abuses become more common as well. The Dutch example should be a cause for concern and hesitation in legalizing euthanasia and physician assisted suicide.
Further Reading:
Neil Gorsuch, The Future of Assisted Suicide and Euthanasia, (Princeton University Press, 2006). (For the Dutch experience, see pages 103-115).
“Death on Demand: Has Euthanasia Gone Too Far,” The Guardian, https://www.theguardian.com/news/2019/jan/18/death-on-demand-has-euthanasia-gone-too-far-netherlands-assisted-dying
Stop Assisted Suicide NY 