The Dutch Euthanasia Law
By Bert P. Dorenbos

The foundation of all law is that every person's life should be protected. The Universal Declaration of Human Rights of 1948, the Charter of the United Nations, the UN declaration on children, and other such documents are all based on the firm principle that life should be protected. No one has a right to kill someone else. Killing cannot be a medical treatment. History is clear from the ancient days of Hippocrates to twentieth-century Nazi doctors that medical professionals violate their own oath if they use their skills to kill a person.

The Dutch discussion leading up to passage of the euthanasia law was carried forward not from the perspective of the patient but from the perspective of the doctor. Government-conducted research indicated that 60 percent of doctors did not report euthanasia cases to the municipal pathologist out of fear of being prosecuted for violating the Dutch Criminal Code. Article 293 of that code makes clear that to kill someone is a crime. And if someone kills another person at that person's request, the punishment can be as much as twelve years in prison. Parliament then decided to amend article 293 of the Criminal Code to exclude doctors from imprisonment if they kill their patients in accord with Section 2 of the "Termination of Life on Request and Assisted Suicide Act."

Making Law Subjective

This change in the law is a dramatic change from the objective rule that no one is allowed to terminate the life of another person. By excluding medical doctors, the Criminal Code has become subjective. There is now the possibility that, in future, other people will also be excluded from potential prosecution. With this change in the code, the protection of every person's life has been made subject to subjective judgment. Now medical doctors can no longer be seen as the fierce protectors of human life. They must decide in each situation whether to accept or reject someone's request to be killed.

As a consequence of this law, Parliament appointed a regional committee composed of an ethicist, a lawyer, and a medical specialist to judge euthanasia cases on their legal merits in order to encourage doctors to report such cases. The results, after two years, however, are that, contrary to expectation, no increase in doctor's reports has occurred. In fact, it appears that an even higher percentage of doctors are not reporting cases. The assumption behind the law is that doctors can be trusted not to misuse their skills to kill. But trust of this kind can never be the foundation of law. Trust has to be proven by evidence and, if needed, by law enforcement.

The text of "Due Care Criteria" of the Euthanasia Act, Chapter II, Section 2 states that the attending physician must:

a. be convinced that the patient has made a voluntary and carefully considered request (to be killed);

b. be convinced that the patient's suffering is unbearable and that there are no prospects of improvement;

c. have informed the patient about his or her situation and prospects;

d. have come to the conclusion, together with the patient, that there is no reasonable alternative in the light of the patient's situation;

e. have consulted with at least one other, independent physician, who must have seen the patient and have given a written opinion on the due care criteria; and

f. have terminated the patient's life or provided assistance with suicide with due medical care and attention.

Legal Nonsense

Now, my first comment on this law is that contrary to common legal practice, it assumes that the person who may have committed a crime will report that crime to the newly established regional committee. Second, by the time of any such report, the patient - in this case the victim - is dead. The victim will not be able to testify that the doctor is either telling the truth or lying. And third, none of these criteria is objective. The only objective fact by the time of a review process is that the doctor has killed the patient.

The conclusion is quite clear: there is no way to make the "due care criteria" objective. And if judgments about life and death have become subjective, every life is in principle subject to shifting rules and measures by an existing government. If, by contrast, life is a given and no one has the right to kill, then the Dutch euthanasia law is very dangerous. For example, the demographic developments in more and more countries around the world show that the population replacement level is already too low to sustain the population. Moreover, the percentage of elderly people is increasing. If the practice of euthanasia is permitted, then the dangers can be anticipated. With the growing cost of healthcare, its financing becomes more and more difficult. Elderly people and those with a "low quality" of life are likely to receive inadequate medical care. Medical teams operating under the permission of the Dutch euthanasia law will more and more easily make decisions about whom to treat and whom to kill. Patients will not know whether the doctor is coming to treat them or to kill them. In a society where killing becomes an option, everyone's life is in danger.

Suffering Can't be Banned

Euthanasia is also an attempt to get rid of suffering. It is quite obvious, however, that it is impossible to ban suffering from society...the answer to suffering is not killing the patient, but caring for the patient. If the doctor cannot cure the patient, the time has come to care for the patient. Palliative care becomes urgent for the dying. The hospice movement in England is an excellent example of how to care for a patient so he or she can die in dignity.?

Excerpted from an article which appeared in "Public Justice Report," Vol. 25, No. 3, 2002 ( www.cpjustice.org ). Reprinted with permission.