Euthana­sia used for 4.5 per­cent of deaths in the Nether­lands

In 2002, the Nether­lands be­came the first coun­try in the world that made it le­gal for doc­tors to help peo­ple die. Both euthana­sia, where doc­tors ac­tively kill pa­tients, and as­sisted sui­cide, where physi­cians pre­scribe pa­tients a lethal dose of drugs, are

Northwest Arkansas Democrat-Gazette - - INTERNATIONAL - MARIA CHENG

LON­DON — Euthana­sia has be­come a com­mon way to die in the Nether­lands, ac­count­ing for 4.5 per­cent of deaths, ac­cord­ing to re­searchers who say re­quests are in­creas­ing from peo­ple who aren’t ter­mi­nally ill.

In 2002, the Nether­lands be­came the first coun­try in the world that made it le­gal for doc­tors to help peo­ple die. Both euthana­sia, where doc­tors ac­tively kill pa­tients, and as­sisted sui­cide, where physi­cians pre­scribe pa­tients a lethal dose of drugs, are al­lowed. Peo­ple must be “suf­fer­ing un­bear­ably” with no hope of re­lief — but their con­di­tion does not have to be fa­tal.

“It looks like pa­tients are now more will­ing to ask for euthana­sia and physi­cians are more will­ing to grant it,” ac­cord­ing to the re­view’s lead au­thor, Dr. Agnes Van der Heide of Eras­mus Univer­sity Med­i­cal Cen­ter in Rot­ter­dam.

The 25-year re­view pub­lished in Thurs­day’s New Eng­land Jour­nal of Medicine is based on physi­cian ques­tion­naires. The use of mor­phine and se­da­tion that might has­ten death has be­come com­mon prac­tice in the Nether­lands, the au­thors said in the re­port.

The re­view shows that in 1990, be­fore it was le­gal, 1.7 per­cent of deaths were from euthana­sia or as­sisted sui­cide. That rose to 4.5 per­cent by 2015. The vast ma­jor­ity — 92 per­cent — had se­ri­ous ill­ness and the rest had health prob­lems from old age, early-stage de­men­tia or psy­chi­atric prob­lems or a com­bi­na­tion. More than a third of those who died were over 80.

Re­quests from those who aren’t ter­mi­nally ill still rep­re­sent a small share but have been in­creas­ing, Van der Heide said.

“When as­sisted dy­ing is be­com­ing the more nor­mal op­tion at the end of life, there is a risk peo­ple will feel more in­clined to ask for it,” she said.

About 8 per­cent of the peo­ple who died in 2015 asked for help dy­ing, the re­view showed. Van der Heide said about half of all re­quests are ap­proved now, com­pared with about a third in pre­vi­ous years.

Scott Kim, a bioethi­cist at the U.S. Na­tional In­sti­tutes of Health who was not part of the study, said the re­port raises con­cerns, par­tic­u­larly in re­gard to peo­ple seek­ing euthana­sia due to age-re­lated is­sues.

“These are old peo­ple who may have health prob­lems, but none of them are life-threat­en­ing. They’re old, they can’t get around, their friends are dead and their chil­dren don’t visit any­more,” he said. “This kind of trend cries out for a dis­cus­sion. Do we think their lives are still worth­while?”

Euthana­sia is also le­gal in Bel­gium, Canada, Colom­bia and Lux­em­bourg. Switzer­land, Ger­many and five U.S. states plus the District of Columbia al­low as­sisted sui­cide.

Some ex­perts said the euthana­sia ex­pe­ri­ence in the Nether­lands of­fered lessons to other coun­tries de­bat­ing sim­i­lar leg­is­la­tion.

“If you le­gal­ize on the broad ba­sis [that] the Dutch have, then this in­crease is what you would ex­pect,” said Pen­ney Lewis, co-di­rec­tor of the Cen­tre of Med­i­cal Law and Ethics at King’s Col­lege Lon­don.

“Doc­tors be­come more con­fi­dent in prac­tic­ing euthana­sia and more pa­tients will start ask­ing for it,” she said. “Without a more re­stric­tive sys­tem, like what you have in Ore­gon, you will nat­u­rally see an in­crease.”

In 1997, Ore­gon be­came the first U.S. state to al­low physi­cian-as­sisted sui­cide for those given six months or less to live. It is now le­gal in Colorado, Cal­i­for­nia, Mon­tana, Ver­mont, Wash­ing­ton state and the District of Columbia.

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