Dutch Take Step to Make Assisted Suicide Legal

Lawmakers in the Netherlands, often in the extreme vanguard of European social change, voted Tuesday to make their nation the first in the world where doctor-assisted suicide is legal.

A euthanasia law, “under which the considered wish of a dying person to put an end to his days is granted, has its place in a mature society,” Dutch Justice Minister Benk Korthals said.

Meeting in The Hague, members of the lower house of parliament voted, 104-40, to legalize euthanasia, provided strict guidelines are observed. Approval by the upper chamber is considered assured because parties in favor of the legislation hold a comfortable majority.

In effect, the legislature is merely giving its blessing to the status quo. Since 1993, physicians in the Netherlands haven’t been prosecuted for giving lethal drugs to patients to help them commit suicide, although doing so has remained a crime that carries a prison sentence of up to 12 years.

The legislation will contribute to the Netherlands’ renown as either a haven of individual liberty and progressive thinking or a society losing its moral underpinnings, depending on one’s point of view. Dutch lawmakers, for example, have also legalized homosexual marriage--a decision personally deplored by Pope John Paul II.

In Amsterdam, meanwhile, coffee shops legally sell marijuana cigarettes and hallucinogenic mushrooms, and prostitutes openly strut their stuff in the windows of row houses along some canals.

Under the new legislation, a physician would have to ascertain that a person was suffering “unbearable” and irremediable physical or mental pain from an incurable condition. The patient would also need to seek a second opinion, and the diagnosis would have to be certified by regional commissions on which yet more doctors sit.

A patient would have to make the request when of sound mind, and do so voluntarily, independently and repeatedly. Doctors are not supposed to suggest suicide as an option. But a patient could make an advance request in writing, giving a doctor the discretion as to what to do when the person became too physically or mentally ill to make such a decision on his or her own.

The new law also requires that the doctor know the patient well--a proviso that would exclude terminally ill Americans or other foreigners who might come to the Netherlands in hopes of finding a release from their suffering.

“There will be no suicide tourism,” said Henk Swarttouw, first secretary at the Dutch Embassy in Paris.

Worried about acquiring an image as a “Doctor Death” to the world, the Netherlands already distributes booklets through its embassies alerting nonresidents that it is “impossible” for them to commit medically aided suicide in the country.

Although no other nation has enshrined in law the practice of euthanasia, Oregon voters approved doctor-assisted suicide for the terminally ill in 1994. Since the law took effect, in 1997, 43 people in Oregon have taken their lives in assisted suicides.

From November 1998 to January of this year, Dutch doctors reported 2,565 instances in which they had assisted patients in ending their lives. Ninety percent of the cases involved people ill with cancer.

According to government estimates, the doctors grant only about one-third of the assisted suicide requests they receive, but it is believed that the number of cases might be double what is actually reported.

“Sometimes a patient asks me to practice euthanasia but does not want his wife or children to know, so I say nothing to the authorities,” one doctor said in an interview Tuesday on Dutch television.

Opponents at home and abroad charged Dutch lawmakers with letting medical care and the dictates of the Hippocratic Oath be replaced by killing. Rita Marker, executive director of the International Anti-Euthanasia Task Force, told the Associated Press that the new law sends a dangerous signal “telling people that if it’s legal, it’s right.”

“It will be like giving the household seal of approval,” Marker said. “What is currently a crime will be transformed into medical treatment.”

Some of the Netherlands’ conservative Christian parties denounced the legislation as a “juridical monster,” while the main opposition Christian Democrats accused the government of betraying its duty “to protect human life.”

“Man holds the reins of his own life in his hands,” countered the leftist reform party Democrats 66, whose member Els Borst, the health minister, drafted the new law.

Opinion polls indicate that a clear majority of the public in the Netherlands supports the legalization, which proponents of patients’ rights and euthanasia have been advocating for a quarter-century. But the three-party coalition government headed by Prime Minister Wim Kok had postponed debate on the bill, originally scheduled for last November.

In the latest version, one bitterly disputed clause in the original has been dropped--a stipulation that even children as young as 12 had the right to request assisted suicide. In the new text, the consent of at least one parent is required for patients up to 16.

In the prevailing Dutch view, the law will put an end to the hypocrisy of having an officially “tolerated” practice that is technically illegal. Five years ago, a Justice Ministry investigation found that half of all assisted suicides in the country were going unreported by physicians because of their fear that they might be prosecuted and their desire to respect patients’ confidentiality.

“What we are going to vote for is to take euthanasia out of the criminal arena,” Justice Ministry spokesman Wijnand Stevens said before Tuesday’s vote.

In 1998, the regional commissions replaced local prosecutors as the official record-keepers of euthanasia cases so that physicians wouldn’t have to enter into contact with the criminal justice system.