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Netherlands, becoming the first country to legalize Euthanasia

Published

November 26, 2020

The mountainous developments in the field of medical science have initiated the option of choosing how and when to end a life which has now become a reality. This development has introduced Euthanasia which is one of the most efficacious ways by which people make life and death decisions for themselves and for others.

Euthanasia is a medical ethical issue with legal, religious, philosophical and political dimensions. Though it is considered to be illegal in most of the parts of the world but is openly practiced in some areas by physicians under certain prescribed circumstances.

Euthanasia or mercy killing is an act or practice of painlessly putting a person to death who is suffering from incurable and painful disease or incapacitating physical disorder by withdrawing life support measures or withholding treatment. Euthanasia refers to several forms of mercy killing involving action or inaction undertaken for the sake of a patient with the intent to cause his death.

For instance, one of the ways of euthanasia is where a doctor may prescribe Predictive genetic test for cancer risk genes which is a muscle relaxant and may eventually lead to the death of a patient.

As a matter of practice Euthanasia may be classified as follows:

Active Euthanasia is a practice where a Physician deliberately ends patient’s life with merciful intentions like by injecting him with a large dose of sedatives.
Passive Euthanasia is where the death of a person is brought about by non-action and occurs either because some form of treatment has been with held or withdrawn either at the request of the patient or because the prolonged life is considered to be futile. For example turning off a life supporting machine so that the patient may die of his condition.
Non-voluntary Euthanasia is where the patient because of some reasons like coma, is unable to take any decision and same is taken by any other person on his behalf because the patient had previously when capable, expressed his wish to be treated in such a manner under such circumstances.
Involuntary Euthanasia is where a patient is killed against his wishes. This is always regarded as murder.

Medical Historians believe that many Greeks did not considered Euthanasia as criminal or unethical. The moral permissibility of the concept of euthanasia is traceable to the Stoics, Plato and Socrates. In 1935, C. Killick Millaed founded the voluntary euthanasia legislation society which leads to the movement for legalization of euthanasia in England.

However in the 19^th century any action or inaction by the care giver, resulting in death of any person was deemed to be unethical and Anglo-American common law regarded it as homicide and assisted suicide. The bill for legitimizing Euthanasia was defeated in the House of Lords in 1936 and 1950 but this initiative in fact laid down the foundation stone of legalization of euthanasia.

Legal developments began to fade away this ban in 20^th century when suicide was decriminalized in some countries and courts began to recognize the right to deny medical treatment. Eventually, this right was further developed into the right of a person to refuse the life supporting system which may result into his death .By the end of the 20^th century this right included within its ambit the right to deny food and water. Such requests could be made either by the patient himself prospectively or by any competent person on his behalf under given conditions.

The decriminalization of euthanasia was approved for the first time by Netherlands with the passing of legislation regarding the practice of assisted suicide which became effective in 2002. This practice of assisted suicide has achieved a status of de facto legality through prosecution policy and Dutch jurisprudence.

Although the letter of Dutch Penal Code still criminalizes Euthanasia but since 1973 Dutch courts have permitted physicians to end patients’ life under certain specific conditions. The Dutch supreme court in 1984, regulating the process of Euthanasia, expressly directed that the death must not cause unnecessary suffering to others, that the second physician must agree with the prognosis and that the patient’s family must be consulted. In 1993, the Dutch Parliament passed the law protecting the doctors who end the life of patients requesting a “dignified death”.

This policy was finalized by the parliament in 2001 by passing a law that legalized Euthanasia and assisted suicide. By virtue of this Law, Doctors in Netherlands can perform both Euthanasia and assisted suicide. While the law approving the same came into effect in 2002, the medical life ending phenomenon has been the medical practice from decades sanctioned by Dutch High court rulings. Those rulings served as guidelines for this practice and ultimately formed the basis for enactment of Termination of life on Request and Assisted Suicide Review Procedures Act 2001.

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The law, in order to attract the approval of Euthanasia, lays down the requirement that a patient must be undergoing through unbearable suffering with no hope of prospectus of improvement. The illness need not be somatic but the euthanasia can be applied in case of mental illness as well.

Since the scope of patients to obtain the approval of death using this Act is very wide hence, substantial trust is placed in the medical profession to maintain the spirit and letter of the law. Despite the wider scope of granting the permission of Euthanasia leading to death of people, what is debated in Netherlands is the ambit of its boundaries and not the existence of the Act perse.

The legalization of Physician assisted-suicide and Euthanasia in Netherlands has lead to the transformation of suicide and assisted death into the preferred mode of managing patients with terminal or serious illness. This method of ending life provides the terminally ill patients with the option to die in a more humane ways and prevents suicide by freeing the patients from the fear of painful incapacitation.

Bindels et al. (1996) conducted a study of AIDS patients in Netherlands and found that more than one third of the patients have made the request of Physician-assisted death as an extreme form of extenuation, applied in the terminal phase of the illness.

In a survey (van der maas, van Delden and pijnenborg 1992) commissioned by the Dutch Government it was found that out of 130,000 death occurring in the Netherlands in 1990, approximately 2,300 were reported cases of active euthanasia and 400 were assisted suicides . 1000 people has hastened deaths without making formal requests for euthanasia and 1900 deaths were cause because of dosage of pain relieving drugs .

Though the practice of Euthanasia is primarily resorted to as a merciful action to end the life of a patient in the scenario of terminal circumstances and disease, overwhelming suffering, trauma trajectory or in an unrelenting persistent vegetative state however, time and again, there has been the public examination of the issue that, is Euthanasia or assisted suicide ethical or moral, should the limits of this practice be restricted to terminally ill patients only or be extended also to persons suffering from debilitating conditions or intolerable life circumstances ? How to know if the decision of a patient to opt for this process is concocted or tutored and not independent?

Even if the Laws and practice relating to Euthanasia is in place but it’s social, philosophical and legal implications are such that it will remain controversial for quite some time to come. The core values of preserving human life and freedom of choice will continue to clash. It will remain subject to various legal challenges and hence raise the issue of whether the criminal justice system is the natural habitat for the governance of medical-life ending behavior , the consensus on which seems very difficult to achieve.

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