Rushing toward death - Euthanasia in the Netherlands

Theo Boer

Theo Boer

Alex Schadenberg, Executive Director - Euthanasia Prevention Coalition

In July 2014, Professor Theo Boer, who was member, for nine years, of a euthanasia regional review committee in the Netherlands, wrote an article that was published in the Daily Mail urging the British parliament to reject the legalization of assisted suicide. Boer then gave the Euthanasia Prevention Coalition permission to publish the full text of his article entitled "Assisted Suicide: Don't go there."

Today Professor Boer published a significant critique of the Netherlands Euthanasia Law under the title: Rushing toward death?

Boer begins by explaining how euthanasia became legal, and how the law works in the Netherlands. He wrote:

In 1994 the Netherlands became the first country to legalize assisted dying. The Dutch added a clause to the Burial and Cremation Act allowing doctors to help a person die as long as the patient made an informed request and faced unbearable suffering with no prospect of improvement; a second doctor concurred in the decision; and medically advised methods were used. The clause was further codified by the Assisted Dying Act in 2001. Belgium followed suit with similar legislation in 2002. 
In the Netherlands, five regional review committees, each consisting of a lawyer, a physician, and an ethicist, were charged with keeping an eye on the practice and assessing (after the fact) whether a case of assisted dying complied with the law. 
Two forms of assisted dying are legally practiced: euthanasia, in which the action of the physician causes death, and physician-assisted suicide, in which a physician provides the patient with a lethal drink administered by the patient. The overwhelming majority of patients who make use of the law (95 percent) choose euthanasia.

Boer then explains why he originally supported the Netherlands euthanasia law.

Link to the full article

Belgian euthanasia ‘dialogue’ continuse to grow

This article was published by HOPE Australia on December 15.

By Paul Russell

Paul Russell

Paul Russell

‘But let us into the debates play the ball instead of the man.’ Says Dr Wim Distlemans in De Morgen in reply to Professor Theo Boers’ observations in yesterday’s Belgian press about the bungled operation of the Belgian Euthanasia Review Commission under Distelmans’ leadership.

Boer, a Dutchman and former member of the Dutch euthanasia review system for nine years entered the debate by reflecting the Dutch standards against the Belgian laisse-faire operation. Boer is critical of Distelmans’ public advocacy role in promoting euthanasia and sees it as contrary to the role of co-chair of the commission charged with reviewing each and every case – including Distelmans’ own cases.

Distelmans in reply, does what he accuses others of and ‘plays the man’. He then tries desperately to deflect Boer’s criticisms by attempting to refocus the debate in other areas. For mine he fails dismally.

He seeks to smear Boer by association, claiming that Boer is being intellectually dishonest by not declaring an association with the anti-euthanasia group Euthanasie Stop, which Distelmans describes as ‘an organization made up of well-known Catholic personalities and militants who are almost professional in their anti-euthanasia battle.’

Does the saying ‘the pot calling the kettle black’ translate well into Flemish? Boer’s only 'association’ with that group, if you can call it that, is that they have republished one of his articles. Death by google search!

Link to the full article

Belgian MP calls for a review of the euthanasia law

This article was published by HOPE Australia on December 14, 2015.

Paul Russell

Paul Russell

By Paul Russell

The open letter from medical professionals critical of the application of the Belgian law on euthanasia to people suffering psychologically has re-ignited debate on the safety and practice of the 2002 law.

Following the letter, Christian Democrat MP, Els Van Hoof, raises significant further questions in the Belgian journal Knack. Van Hoof is severely critical of the development of the Belgian law and the amendment to include children in 2013 when, at no time over the more than a dozen years of operation has the law been formally reviewed.

‘Since 2013 I follow as an MEP intensive debates on euthanasia. The stakes of these debates was always the expansion of the existing Euthanasia Act of 2002, which allows euthanasia for adults. I then repeatedly asked the commission why should we decide to expand if there had not even done an assessment was made of the existing law on euthanasia. For it was clear that the law showed serious gaps, particularly with regard to the "safety valves" that are built to prevent abuses.’

van Hoof says that her repeated requests in the parliament for a review were blocked by an opposing majority on every occasion. She acknowledges that she is not arguing for the repeal of the law, but to improve it. Refusing a timely opportunity for review at the moment of a grave debate on child euthanasia would seem negligent.

Van Hoof is critical of the breadth of interpretation of the terms of the original law: “… the terms "medically hopeless situation" and "unbearable psychological suffering which cannot be alleviated" must be interpreted by the physician. In practice, this leads to an extremely subjective interpretation by the clinician, thus reducing the risk exists that it is too early proceeded to euthanasia.”

Van Hoof goes further than the academics in their open letter by also criticising the so-called safeguards in the Belgian law. In respect to euthanasia for psychological suffering, three doctors must be consulted. The problem Van Hoof notes is that opinions to the contrary need not be observed; the reality is that only one positive opinion is necessary – that of the doctor with the needle.

Link to the full article

Netherlands 2014 euthanasia report - another 10% increase

By Alex Schadenberg, Executive Director - Euthanasia Prevention Coalition

The 2014 Netherlands euthanasia report was released indicating that there was another 10% increase in assisted deaths. There were also 41 assisted deaths for psychiatric reasons and 81 assisted deaths for dementia. The term assisted death refers to deaths by euthanasia and assisted suicide.

The 2014 report stated that there were reported 5306 assisted deaths up from 4829 reported assisted deaths in 2013. These numbers do not include the unreported assisted deaths.

Every five year the Netherlands has a meta-analysis euthanasia study. In 2010 the Lancet study indicated that 23% of all assisted deaths were unreported in the Netherlands.

The number of assisted deaths in the Netherlands continues to increase.

Last year, Theo Boer, a Dutch ethicist, and a 9 year member of a Netherlands regional euthanasia review committee, changed his mind about euthanasia.

Link to the full article

California Governor should have talked to Holland before signing bill

By Alex Schadenberg, Executive Director, Euthanasia Prevention Coalition

Professor Theo Boer

Professor Theo Boer

Professor Theo Boer, who was a member of a regional euthanasia review committee for 9 years, and then changed his mind to now oppose legalizing euthanasia, wrote an opinion article that was published in - The Press Democrat in California.

Boer argues that California Governor Jerry Brown should have talked to Holland before he signed the assisted suicide bill. Boer wrote:

Now that Gov. Jerry Brown has signed the End of Life Option Act, my thoughts go back more than 20 years to the early days of assisted dying in the Netherlands. And I can’t help but feel we — the Dutch — were naïve on this issue. 
In 1994, the Dutch were the first in the world to officially legalize assisted dying. It was a modest beginning, just as California’s is now. With no country going before us, assisted dying was formalized in a special clause in the Burial and Cremation Act. If a number of safeguards were kept, doctors acting in accordance with them would not be prosecuted. A separate euthanasia law followed in 2001, not differing much from the 1994 clause and with Belgium following its northern neighbor in 2002. 
Five regional review committees, consisting of a lawyer, a physician and an ethicist, keep an eye on the practice and assess whether each case of assisted dying has been in accordance with the law. I served on one of the committees from 2005-2014 and reviewed around 4,000 cases. Given the widespread support for assisted dying in the Netherlands, I was convinced that legalizing assisted dying was the wisest and most respectful route.

Boer explains what happened to the culture in the Netherlands

Link to the full article

Euthanasia in Belgium: Dateline special report: Allow me to die

Paul Russell

Paul Russell

This article was published on the HOPE Australia website on September 16.

By Paul Russell

The documentary filmed by the Australian Special Broadcasting Service (SBS) and made by their highly regarded European Correspondent, Brett Mason looked at the Belgian euthanasia regime through the lens of personal stories.

As the documentary unfolds we hear clearly from Mason, a voice of concern. To his credit, both in the documentary and in his blog story, he doesn’t put his own views nor conclusions. Clearly, however, the reality of euthanasia is very different from his initial conceptual thoughts as evidenced in these comments from the blog:

“I was taken aback - not for the first time in recent weeks - by just how mundane and unremarkable euthanasia is to those who perform it.” 
“I’m unable to bury a burning sense of anguish in the pit of my stomach. While I fully accept and respect that this decision was the patient’s and the patient’s alone, over these last nine months I’ve been filming in Belgium questions have repeatedly been asked about how this nation’s euthanasia laws are safeguarded.”

Reflection during the program came in the testimonies of Belgian, Tom Mortier, whose mother was euthanased without his knowledge and Dutch Professor, Theo Boer, who had formerly been a member of one of the Dutch euthanasia review committees. Both had formerly supported their countries laws. It would be wrong to suggest that Professor Boer is now totally opposed, but Tom Mortier most certainly is so. Both raised concerns that the Belgian and Dutch laws had moved far beyond any initial sense and remit as being only for terminally ill people and only at the end of life when all else had failed.

The documentary then follows two people contemplating euthanasia. Neither, it should be said, are terminally ill.

Link to the full article

Study: "Tired of living" and dementia are common reasons for euthanasia at Dutch euthanasia clinic

By Alex Schadenberg, International Chair, Euthanasia Prevention Coalition

Alex Schadenberg

Alex Schadenberg

A study released in the Journal of the American Medical Association (JAMA) analyzing the euthanasia deaths in the first year of operation at the Netherlands euthanasia clinic appears to have been done to prove that euthanasia is being done carefully at the clinic. 

The study: A study of the First Year of the End-of-Life Clinic for Physician-Assisted Dying in the Netherlands was published online on August 10, 2015.

The data shows that in its first year of operation (March 1, 2012 - March 1, 2013) the Netherlands euthanasia clinic received 645 requests for assisted death and lethally injected 162 people. 

Of the 162 who died by an assisted death, the data indicates that 6 assisted deaths were done for psychological reasons, 21 assisted deaths were done for cognitive decline, such as dementia and 11 assisted deaths were done based on "tired of living." Tired of living means that the person does not have any specific illness.

The study indicates that woman represented 62% (Table 1) of the requests for euthanasia and 65% (Table 3) of the euthanasia deaths.

This study represented the first year of operation for the euthanasia clinic. A recent news report indicated that the number of euthanasia deaths for psychiatric patients has increased substantially.

Link to the full article