Voluntary euthanasia an acceptable way of dying in the Netherlands

Press, 20 April 1987, Page 16

Voluntary euthanasia an acceptable way of dying in the Netherlands

VOLUNTARY EUTHANASIA has become so common in the Netherlands — at least 5000 cases a year, a survey indicates — that courts no longer deem it a crime requiring imprisonment of doctors administering it under certain medical criteria.

After years of debate, .voluntary euthanasia has become accepted by broad segments of the population and by far the largest part of the medical profession, said Professor Leo Fretz, a philosophy professor at the nearby Delft Institute of Technology and chairman of the Dutch Voluntary Euthanasia Association.

A recent opinion poll commissioned by a Roman Catholic broadcasting station found 76 per cent of the Dutch favouring limited legalisation for mercy killing. A recent medical journal survey of doctors indicated a rate of at least 5000 euthanasia deaths a year, which would make the Netherlands the European leader of the practice, if not the world.

Professor Fretz called the survey figure of 5000 mercy killings annually a conservative estimate, noting that those cases involved only incurables, released from hospitals to die .at home. Other estimates range from 6000 to 20,000 cases a year, Professor Fretz said, but he

By

ROLAND de LIGNY,

of Associated Press,

in The Hague

added that the higher figure was pretty wild, given an annual mortality of 120,000 in this nation of 14.6 million. Euthanasia has been the focus of a political, religious and social debate'in the Netherlands for’a decade, pitting anti-euthanasia religious forces against the nation’s strong civil-libertarian movement

Last year, the issue almost broke up Prime Minister Ruud Lubber’s Centre-Right coalition of anti-euthanasia Christian Democrats and pro-euthanasia Right-wing Liberals. Mr Lubber’s Government plans to submit limited legislation later this year allowing voluntary euthanasia for terminally ill patients in unbearable pain, if physicians and family concur. Dutch law sets a 12-year maximum prison sentence for euthanasia. But courts in recent years have passed only token suspended sentences on doctors observing mercy killing criteria set by the Royal Dutch Medical Association.

That jurisprudence has been developed with the utmost care, and must be seen as a signal from the courts to the medical

profession that euthanasia, under very strict conditions, has gained acceptance, Professor Fretz said in an interview.

Principles adopted in February by the medical association’s largest nurses’ association, allow mercy killing by a physician at the patient’s well-considered request in cases of unacceptable suffering. The guidelines also call for consultation, with other doctors on a final decision.

“The emphasis on the aspect of free will is very important to us,” Professor Fretz said. “Otherwise, we’d be on a very slippery slope as far as psychiatric cases and comatose patients are concerned.”

His association opposes euthanasia without patient request, thus avoiding controversies like those surrounding the removal of life-support systems from incurably comatose patients. ’’

“It would be a misunderstanding to state that we were proeuthanasia, period,” Professor Fretz said. “Every death is a drama. Killing someone in selfdefence is a drama, but it’s not considered immoral. We think it should be the same with volun-

tary mercy killing — a drama, but not immoral.” His association’s drive for limited legalisation, he added, is motivated by the wish to let people exercise their human rights — “and that’s not only the right to life, but also the right to the pursuit of happiness, to live in freedom.”

Euthanasia crops up from time to time in other countries around the world, but more recent emphasis is on what’s regarded as the futile prolongation of life through life-support equipment. This differs from the Dutch practice, which permits mercy killing through lethal injection, for example.

Under the Dutch Government’s proposal, guidelines similar to the medical association’s would become part of the medical profession law defining a physician’s responsibilities. That proposal is a compromise attempt to break the political deadlock over the issue.

At the height of last year’s Government crisis over euthanasia, Mr Lubber’s party reportedly threatened to quit the Cabinet if the Liberals supported Opposition legislation in Parliament that would allow patient-re-quested euthanasia in cases of a hopeless situation of physical and

mental need. The Government claimed the standard would open the door to abuse in psychiatric cases.

The Government’s new proposal is set for Parliamentary debate in the autumn.

- “It looks as if the status quo of the past years will be formalised, and we see that as a very positive development,” Professor Fretz said. "Limited legalisation will lead to legal clarity and avoid situations like that at Amsterdam’s Free University.” In January, three nurses at the Free University Hospital allegedly admitted giving lethal injections to three incurably ill comatose patients out of pity. They had apparently not consulted the patients’ families or physicians, and face trial for murder this spring. “This case proves that legislation clearly defining the responsibilities in euthanasia cases is urgently needed,” said Mr Jan Schaart, spokesman for the nurses’ association. He claimed the Free University case is only the tip of the iceberg.

Professor Fretz maintains, that illegal euthanasia occurs everywhere in the - industrialised world, where advanced medical technology now allows for the almost interminable prolongation of life in many cases.