Medical-Ethical Decisions and Life-Terminating Actions in The Netherlands 1990-1995

Evaluation of the Second Survey of the Practice of Euthanasia

Abstract

The paper deals with a critical evaluation of the Second Survey of the Practice of Euthanasia in The Netherlands. First of all, the authors underline that the Dutch law requests a notification or reporting procedure on euthanasia through a schedule annexed to article 10 of the law. This procedure also applies to cases of active termination of life without explicit request and it implies that involved physician does not issue a certificate of natural death, but reports the event to the municipal coroner by means of a completed list of some fifty points of attention.

One of the main points of criticism of the Dutch regulation of euthanasia concerns the question whether the notification procedure actually makes the practice of euthanasia verifiable. From the outset it appeared that only a minority of physicians - 25% of general practitioners and 35% of the specialists according the First Survey on Euthanasia (1990) - report cases of active termination of life to avoid legal problems and the questioning of the relatives of the patient.

In 1994, the Dutch government decided to have a new large-scale survey conducted as to the practice of euthanasia and the effectiveness of the notification procedure. This Second Survey on euthanasia, edited in 1995, shows: 1. a substantial increase has occurred in the number of cases of euthanasia; 2. a very little number of notification procedures has confirmed. Apart from the fundamental ethical objection to a plea of necessity in the case of life-terminating actions, it is apparent that in practice the notification procedure has not led also to effective control of euthanasia, according to Dutch legislator.