In the Netherlands, if a patient no longer wishes to live, a doctor is authorised to help him or her to put an end to their life. In the past decades euthanasia has become accepted by ever more Dutch people. Yet, euthanasia remains a complex and delicate issue. When is euthanasia allowed? What is the role of the doctor?
Euthanasia and assistance in suicide are no longer punishable in the Netherlands since 2002. However, strict rules have been laid down in the Termination of Life on Request and Assisted Suicide (Review Procedures) Act (WTL), the Euthanasia Act. In case of euthanasia strict criteria of due care have to be met, the so-called grounds for excluding criminal liability, which can only be invoked by a medical practitioner, provided that he meets the requirements of due care and reports the euthanasia to the municipal coroner. Subsequently, a regional euthanasia review committee will assess whether the doctor has met the requirements of due care.
In their annual report the regional euthanasia review committees account for the way in which they assess compliance with the Termination of Life on Request and Assisted Suicide (Review Procedures) Act (WTL). In 2010, 3136 cases of termination of life on request or assisted suicide were reported to the regional committees, a 19% increase as compared to 2009. The WTL will soon be evaluated in order to identify the reasons for the increase.
In May 2008 the then state secretary of Health Welfare and Sport, Ms Jet Bussemaker, commissioned research on euthanasia, specifically on the knowledge and opinions of the public and the professionals about medical decisions and treatment with regard to termination of life. The research shows that there is broad support for the Euthanasia Act in the Netherlands. Among physicians, nurses and care personnel, the knowledge level about the Euthanasia Act is high. Public knowledge about euthanasia and other decisions with regard to the end of a person's life, on the contrary, is below par.
The doctor's role
In order to make sure that medical practitioners are well acquainted with euthanasia issues, the Royal Dutch Medical Association (KNMG) has drafted a position paper, stating the role, the responsibilities, the possibilities and the limits of the doctor with regard to euthanasia, for example in case of accumulation of geriatric complaints, early dementia symptoms or chronic mental illness. The KNMG position paper provides doctors with criteria and a clear picture of their role in case of voluntary termination of life.
Termination of life clinic
Since 1973, Right to die NL (NVVE) has been devoting itself to social acceptance of euthanasia in the Netherlands. In January 2011 the organisation presented its plans to set up a termination of life clinic. This clinic could open its doors in 2012 and receive about 1000 people per year, especially people who meet the legal criteria for euthanasia, but whose death wish has not been honoured by their own doctor. KNMG denounces the plans for such a clinic, on the ground that care should not merely focus on the patient's death wish, but also on alternatives and other care issues.
Euthanasia, the Netherlands' new rules - publication of the Dutch Ministry of Health, Welfare and Sport
KNMG position paper: The role of the physician in the voluntary termination of life (2011)
NVVE English website
Euthanasia and assisted suicide - BBC website