Netherlands Is Europe’s Mercy-Killing Capital

Voluntary euthanasia has become so common in the Netherlands--at least 5,000 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 Leo Fretz, a philosophy professor at the Delft Institute of Technology and chairman of the Dutch Voluntary Euthanasia Assn.

A recent opinion poll commissioned by a Roman Catholic broadcasting station found that 76% of the Dutch favored limited legalization of mercy killing.

A recent medical journal survey of doctors indicated a rate of at least 5,000 euthanasia deaths a year, which would make the Netherlands the European, if not the world, leader of the practice.

‘Conservative Estimate’

Fretz called the survey figure of 5,000 mercy killings annually a “conservative estimate,” noting that those cases involved only incurables released from hospitals to die at home.

“Other estimates range from 6,000 to 20,000 cases a year,” Fretz said. But he 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 Premier Ruud Lubbers’ center-right coalition of anti-euthanasia Christian Democrats and pro-euthanasia right-wing Liberals.

Legislation Planned

Lubbers’ 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 who were observing mercy killing criteria set by the Royal Dutch Medical Assn.

“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,” Fretz said in an interview.

Those conditions, officially adopted in February by the medical association and the nation’s largest nurses’ association, allow mercy killing by a physician at the patient’s “well-considered” request in cases of “unacceptable suffering.”

Free Will Important

The guidelines also call for consultations by the physician with other doctors in each case.

“The emphasis on the aspect of free will is very important to us,” 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’re pro-euthanasia, period,” Fretz said. “Every death is a drama. Killing someone in self-defense is a drama, but it’s not considered immoral. We think it should be the same with voluntary mercy killing--a drama but not immoral.”

Human Rights Issue

His association’s drive for limited legalization, 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 as an issue in the United States. But more recent emphasis among American groups is on what they regard as the futile prolongation of death illness 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.

Political Crisis

At the height of last year’s government crisis over euthanasia, Lubbers’ party reportedly threatened to quit the Cabinet if the Liberals supported opposition legislation in Parliament that would allow patient-requested euthanasia in cases of “a hopeless situation of physical and mental need.” The government claimed that the standard would open the door to abuse in psychiatric cases.

The government’s new proposal is set for parliamentary debate in the fall.

“It looks as if the status quo of the past years will be formalized, and we see that as a very positive development,” Fretz said. “Limited legalization will lead to legal clarity and avoid situations like that at Amsterdam’s Free University.”

In January, three nurses at 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.

‘Tip of Iceberg’

“This case proves that legislation clearly defining the responsibilities in euthanasia cases is urgently needed,” Jan Schaart, spokesman for the nurses association, said. He claimed that the Free University case “is only the tip of the iceberg.”

Fretz maintains that although it is illegal, “euthanasia occurs everywhere in the industrialized world, where advanced medical technology now allows for the almost interminable prolongation of life in many cases.”