Under-ground euthanasia in the Netherlands

This article was published on November 28 by Bioedge.

By Michael Cook

The leading Dutch right-to-die society is seeking talks with the Dutch medical association (KNMG) for approval of a “peaceful pill” which will allow its members to kill themselves without the help of a doctor.

As usually happens in the progress of euthanasia, supporters are now telling the media that this already occurs illegally on a vast scale and that legislation is essential to guard against abuses.

People who believe that their lives are “complete”, need a pill, says the Dutch Association for a Voluntary End of Life (NVVE) in a recently-published policy paper. The details have yet to be worked out with the Ministry of Health and the Ministry of Security and Justice and the KNMG. As the NVVE acknowledges, the peaceful pill could be used to murder people, or taken impulsively by otherwise healthy people, or used by young people with mental health issues. Therefore the NVVE would like to run a pilot project so that authorities will have “scientific research” to back up a decision.

NVVE director Robert Schurink told the media

“We see that society wants such a pill, particularly among the babyboomer generation which is not afraid to speak its mind. They want control over the end of their lives.”

For the first time, NVVE and another group, Stiftung De Einder, have acknowledged that they are already promoting a “peaceful pill” outside the existing legal framework. The lethal drugs are ordered from overseas. From China come pills and from Mexico come liquid barbiturates. The packages arrive quickly, sometimes disguised as a birthday card. NRC says that although this arrangement is illegal, there is no chance that the public prosecutor will charge anyone.

About 5300 people are euthanased legally in the Netherlands every year. The NVVE did not disclose how many commit suicide using overseas drugs over and above this figure. De Einder told NRC that it had given advice about its own service to 607 clients last year, although it is unclear how many committed suicide.

One of NVVE’s clients is 75-year-old Jannes Mulder, a doctor who had helped to euthanase several people himself. A feature story in the NRC describes how he contacted China:

Mulder ordered through the mail powder for two people – himself and his wife. Payment was made through Western Union. Two weeks later came a brown envelope with red Chinese postmarks. There was a birthday card for “John”: happy birthday. It is a subterfuge that Chinese suppliers often use. Inside the card was a sachet of powder. Mulder put it in the basement. Those around him know about it -- Jannes H. Mulder is in charge of his own life. He will soon test some of the powder on his goldfish. "I want to make sure it works," he says.

NRC also tells the story of another client, 83-year-old Tom van Manen, who stirred the Chinese powder into his breakfast yoghurt one morning in 2012 with the help of his daughter, Kika Notten. It sounds like a typical “completed life” scenario – except that van Manen was quite demented and may not have understood what he was doing. Ms Notten knew that she was in a grey zone, legally speaking. However, she was careful to inform a local doctor and two police officers. They did nothing.

Netherlands euthanasia lobby pushes kill pill

By Alex Schadenberg, International Chair, Euthanasia Prevention Coalition

The Netherlands euthanasia lobby (NVVE) has renewed their push for a kill pill that would be made available, free of charge and upon request, to people who are 70 or older. 

In 2010, the Netherlands euthanasia lobby collected signatures supporting the "last will pill" for people over 70. According to a report in the Dutch News:

The NVVE now wants to discuss its ideas for an experiment with the health and justice ministries and with the Dutch doctors’ association KNMG. 
‘We see that society wants such a pill, particularly among the babyboom generation which is not afraid to speak its mind,’ NVVE director Robert Schurink told the NRC. ‘They want control over the end of their lives.’ 
At the moment, the NVVE helps people who do not want to live any longer access foreign suppliers who can help them buy the pills to do the job, the paper said.

The concept of the kill pill comes from a few "academics" who philosophically believe that death is the ultimate freedom. They really don't care that their philosophy threatens the lives of the many so a few academics can say - "I am free."

What about people who are living with situational depression, or for example someone who is grieving a lost spouse. Is it freedom to assist the suicide of someone who is living through the dark time of their life? No it is a form of social abandonment and the ultimate form of elder abuse.

It is bad enough that the Netherlands allow euthanasia, but to simply say - "Oh by the way I am tired of living, give me the kill pill" is a dangerous and callous response.

Belgian Euthanasia Commission refers case for judiciary review

This article was published by HOPE Australia on October 29, 2015.

Paul Russell

Paul Russell

By Paul Russell, the director of HOPE Australia.

De Standaard newspaper is reporting today that, for the very first time since its inception in October 2002, the Belgian Euthanasia Commission has referred a reported euthanasia case to the judiciary for review.

The case in question is well known as it was recorded by the Australian SBS TV Network reporter, Brett Mason, in a Dateline documentary aired in Australia in September. As Mason reported:

“Simona de Moor is a physically healthy 85-year-old. She lives in a care home in Antwerp, but is still active and on no medication. 
However, she’s been unable to accept the death of her daughter Vivian from a heart attack three months earlier, and sees no reason to go on.”

De Standaard reports:

"The doctor in question has not complied with the conditions imposed by the law, ruled the 16 members on Tuesday unanimously. Palliative physician and co-chair of the Committee Wim Distelmans confirmed the news to the newspaper. "If there is any doubt about the terms, we must continue to court." 
The doctor in question is Marc Van Hoey, also chairman of the association "Right to die with dignity." He applied to euthanasia on Simona De Moor, a 85-year-old woman who died on June 22 of this year in Antwerp."

Van Hoey is no stranger to the controversies associated with the application of Belgium's euthansia laws.

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

Mixed signals from the Netherlands and Belgium about euthanasia

This first appeared at bioedge.org and is republished with permission.

By Michael Cook

There is good news and bad news about euthanasia from the Netherlands and Belgium in JAMA Internal Medicine earlier this month. But which is which depends on which side of the fence you sit.

From the Netherlands comes a report about how a euthanasia clinic which handled people whose regular doctor had rejected their request for euthanasia. The staff of the Levenseindekliniek are clearly more committed to euthanasia than the general run of Dutch doctors. However, they still turned away nearly half of the requests for euthanasia and physician-assisted suicide, mostly because these patients only had psychological suffering or were tired of living.

The clinic has a reputation for aggressively pushing euthanasia. Of the 162 patients it euthanized in 2012, the year of study, 8.2% were suffering from a psychological or psychiatric ailment and 7% were “tired of life.” It has a growing fleet of mobile vans (about 40 at the moment) which buzz around the countryside assessing patient’s requests for euthanasia. Nevertheless, it “granted fewer requests for euthanasia and physician-assisted suicide than are granted in the Netherlands on the whole.”

So the report – which was funded by the end-of-life clinic — paints a picture of moderation and sound judgment on the part of euthanasia doctors.

From Flanders, the Dutch-speaking region of Belgium, comes a different picture. Belgium legalized euthanasia in 2002. Between 2007 and 2013, the prevalence of euthanasia there rose from 1.9% to 4.6% of all deaths. One in every 20 deaths is by euthanasia nowadays. The Flemish authors attempt to explain this enormous change in social mores.

First, they argue that “values of autonomy and self-determination” have become more important for the Flemish. And approval of euthanasia continues to rise, perhaps with the help of very positive reporting in the media.

The second reason is that doctors are more willing to perform euthanasia. Like their fellow citizens, they esteem autonomy, but they also are confident that they will not be prosecuted. Euthanasia is treated “as part of the palliative care continuum, as formally expressed in a position statement from the Federation of Palliative Care Flanders.”

American observers were alarmed by this new data. “As the number of overall deaths like this becomes more frequent than 1 in 20, say, I think red flags really need to be raised,” the author of a commentary in the same issue, Dr. Barron Lerner told Reuters [1]

“Most of us were trained to never condone speeding death at all,” he added. 
“To the degree that some physicians are comfortable doing so, they will be in cases in which someone has an intractable physical suffering that will only persist or get worse; it is quite a leap for most of us to also see psychological suffering as a valid reason for speeding death.”

[1] Dr. Lerner and bioethicist Arthur Caplan wrote a commentary for JAMA Internal medicine titled “Euthanasia in Belgium and the NetherlandsOn a Slippery Slope?” [http://archinte.jamanetwork.com/article.aspx?articleid=2426425].

The continual expansion of euthanasia in the Netherlands and Belgium

Alex Schadenberg

Alex Schadenberg

By Alex Schadenberg, Executive Director, Euthanasia Prevention Coalition

The Washington Post published a very well researched article by Charles Lane on August 19, 2015 titled: Europe's sinister expansion of euthanasia. This same article was republished in the National Post and several other major newspapers.

Lane examined the date from the recent research concerning the Belgian euthanasia law. I have written similar articles, but to his credit, Lane has been published by major newspapers.

Lane first examines the data from a Study: concerning 100 requests for euthanasia for psychiatric reasons in Belgium. Lane remarks that:

Between October 2007 and December 2011, 100 people went to a clinic in Belgium’s Dutch-speaking region with depression, or schizophrenia, or, in several cases, Asperger’s syndrome, seeking euthanasia. The doctors, satisfied that 48 of the patients were in earnest, and that their conditions were “untreatable” and “unbearable,” offered them lethal injection; 35 went through with it. 
These facts come not from a police report but an article by one of the clinic’s psychiatrists, Lieve Thienpont, in the British journal BMJ Open. All was perfectly legal under Belgium’s 2002 euthanasia statute, which applies not only to terminal physical illness, still the vast majority of cases, but also to an apparently growing minority of psychological ones. Official figures show nine cases of euthanasia due to “neuropsychiatric” disorders in the two-year period 2004-2005; in 2012-2013, the number had risen to 120, or 4 percent of the total.

Lane then examines the data from a study concerning the: First Year of the End-of-Life Clinic for Physician-Assisted Dying in the Netherlands.

Link to the full article

The narcissism of assisted suicide

This article was published on August 11, 2015 by Spiked.

A shocking case that shows that assisted suicide is about more than alleviating suffering.

Dr Kevin Yuill

Dr Kevin Yuill

By Dr Kevin Yuill, an academic and an author.

In his sharply observed book The Culture of Narcissism, the American social critic Christopher Lasch remarked that, in modern life, ‘The usual defences against the ravages of age – identification with ethical or artistic values beyond one’s immediate interests, intellectual curiosity, the consoling emotional warmth derived from happy relationships in the past – can do nothing for the narcissist’. 

In a generation that has forgotten that it stands in the midst of a long line of past and future generations, Lasch noted, many live ‘for the feeling, the momentary illusion, of personal wellbeing, health, and psychic security’.

As Lasch later lamented, his exploration of narcissism was widely misunderstood. In his writing, narcissism referred not to a confident self-centredness, but to the inability of an entire culture to see beyond the corners of itself, to understand the self’s place in history, or to believe in its ability rationally to control the future. Lasch claimed that the survival of the self – not self-improvement – had become the highest aspiration.

There is more than a whiff of narcissistic survivalism in the openness of many Western societies to assisted suicide. This was best symbolised by the trip Gill Pharaoh, a healthy, 75-year-old retired nurse, took to the LifeCircle suicide clinic in Switzerland. Pharaoh, who died on 21 July this year, was not ill, but wished to die. She noted in her final blog that she wanted ‘people to remember me as I now am – as a bit worn around the edges but still recognisably me!’.

This ‘snapshot’ sentiment, whereby we preserve ourselves for posterity, is surely illusory. We can neither control how people remember us nor can we preserve a moment in time. There is no perfect moment or ideal physical presence, no ‘real me’, because life is a process, constantly unfolding. We continually learn and change, and the ‘authentic’ self cannot be captured at one specific time. Nor is a ‘perfect’ or merely ‘good’ death meaningful to the deceased. Killing oneself does not preserve anything – it destroys the prospect of further experiences and interactions.

Link to the full article