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Australia Australia Chronology Euthanasia advocates work to make suicide easy. Belgium Belgian Law on Euthanasia Belgium Chronology Canada Canada Chronology England England Chronology Germany Germany Chronology Netherlands Clinical Problems With the Performance of Euthanasia and Physician-Assisted Suicide in the Netherlands Killing Babies, Compassionately. The Netherlands follows in Germany?s footsteps. Netherlands Chronology Netherlands Summary Seduced by Death: Doctors, Patients, and Assisted Suicide The Slippery Slope: The Dutch Example New Zealand New Zealand Chronology Switzerland Assisted Suicide and Euthanasia in Switzerland Assisted-Suicide in Switzerland Open Regulation and Practice in Assisted Dying Switzerland Chronology |
The Slippery Slope: The Dutch Example Herbert Hendin, The Slippery Slope: The Dutch Example, 35 DUQ. L. REV. 427 (1996)Once physician-assisted suicide is legally permitted for patients designated as terminally ill, the gradual extension of the practice to ever-widening groups of patients has been referred to as the slippery slope. The Netherlands, where doctors are able to practice euthanasia as long as they follow certain established guidelines, provides empirical example of what the slippery slope means in actual practice. Over the past two decades, Dutch law and Dutch medicine have evolved from accepting assisted suicide to accepting euthanasia, and from euthanasia for terminally ill patients to euthanasia for chronically ill individuals. It then evolved from euthanasia for physical illness to euthanasia for psychological distress. Finally, it evolved from voluntary euthanasia to the practice and conditional acceptance of non-voluntary and involuntary euthanasia. Once the Dutch permitted assisted suicide, it was not possible medically, legally, or morally to deny more active medical help such as euthanasia to individuals who could not effect their own deaths. The Dutch could also not deny assisted suicide or euthanasia to the chronically ill, who have longer to suffer than the terminally ill, or to individuals who have psychological pain not associated with physical disease. To refuse assisted suicide or euthanasia to these individuals would be a form of discrimination. Although involuntary euthanasia has not been legally sanctioned by the Dutch, it has increasingly been justified or excused as necessary by the need to relieve suffering patients who are not competent to choose a course of action for themselves. The inability to regulate euthanasia within established rules is even more slippery. Virtually every guideline established by the Dutch ? whether it be a voluntary, well-considered, persistent request; intolerable suffering that cannot be relieved; consultation; or the reporting of cases ? has failed to protect patients or has been modified or violated with impunity. The Remmelink Report, the Dutch government's official commissioned study of euthanasia, revealed that more than half of Dutch physicians consider it appropriate to introduce the subject of euthanasia to their patients. The doctors seem not to recognize that they are also telling the patient that his or her life is not worth living, a message that has a powerful effect on the patient's outlook and decision. In a study of euthanasia conducted in Dutch hospitals, doctors and nurses reported that more euthanasia requests came from the families of patients than the patients themselves. The investigator for the study concluded that the families, the doctors, and the nurses were involved in pressuring patients to request euthanasia. The public has the illusion that legalizing assisted suicide and euthanasia will give individuals greater autonomy. The Dutch experience teaches that the reverse is true. Legal sanction of assisted suicide and euthanasia actually increases the power and control of doctors, who can suggest or encourage the practice, not propose obvious alternatives; ignore patients' ambivalence; and even put to death patients who have not requested it. Our society has an opportunity to learn from the Dutch mistakes. It would be sad simply to repeat them. Posted on June 26, 2004. |