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Dutch Parliament Approves Euthanasia Bill

Thursday, August 20, 1970

In what was both feared and celebrated as a morally groundbreaking decision, the Dutch Senate on Tuesday enshrined in law a terminally ill patient's right to suicide and a doctor's immunity from prosecution for assisting.The following news items come to us from John Hofsess (jh@rights.org)

Dutch Parliament Approves Euthanasia Bill

Netherlands OKs Assisted Suicide (Los Angeles Times, April 11)

Dutch Senators Pass Mercy-Killing Bill (National Post, April 11)

Dutch Hope Euthanasia Law Will Prompt Debate (Globe and Mail, April 11)

Death Law May Attract Travellers (The Age - Melbourne; April 12)

Horror Expressed in Germany Over Dutch Euthanasia (NEW YORK TIMES, April 12)

Netherlands OKs Assisted Suicide

(Los Angeles Times; Wednesday, April 11, 2001)

Europe: Despite 11th-hour protests, Dutch government becomes first to fully legalize euthanasia.

By CAROL J. WILLIAMS, Times Staff Writer

AMSTERDAM--In what was both feared and celebrated as a morally groundbreaking decision, the Dutch Senate on Tuesday enshrined in law a terminally ill patient's right to suicide and a doctor's immunity from prosecution for assisting.

The decision, which makes the Netherlands the first country to fully legalize euthanasia, was three decades in the making and stirred an eleventh-hour outbreak of religious and conservative opposition. But it had the support of nearly 90% of Dutch citizens as a humane alternative to a painful and undignified death.

Euthanasia has been tolerated here for years, but the majority of citizens and health care professionals wanted a legal framework to protect physicians deterred from ending the suffering of patients by fear of punishment. Until now, assisting in the death of a person was a criminal offense punishable by as much as 12 years in prison, although no one has served time for administering euthanasia since the 1970s.

"This law will remove the uncertainty for patients and for doctors," Health Minister Els Borst told the Senate before its 46-28 decision to approve a bill endorsed by the lower house of parliament in November. The law will takeeffect as soon as it is signed by Queen Beatrix and published in official journals--technicalities expected to take two weeks.

Justice Minister Benk Korthals also hailed the legislation as an end to the legal limbo in which doctors have found themselves in a society that so clearly supported the right to assisted suicide but with a penal code that didn't.

The Senate action culminated a 27-year campaign by the Dutch Voluntary Euthanasia Society, which praised the legislature's action as a courageous step in ensuring individual rights.

"This is an important and sensitive decision, and concerns about abuse are unfounded," said the society's managing director, Rob Jonquiere. "Abuse is only possible when there is no legal framework, which is the problem we resolved today."

"Someone has to be first. There is nothing to be proud of or to be ashamed of," said Jacob Kohnstamm, the euthanasia society's president and spokesman for the moderate D66 political party, which supported the legislation.

Outside the Senate building in The Hague, though, several thousand demonstrators hoisted placards denouncing euthanasia as "murder" and "Nazi morality."

"It is dangerous and unworthy for a civilized society if doctors are allowed to kill. It could put people under pressure to choose death," warned Kars Veling, a senator from the Christian Union party, which opposed the legislation. Another party member, Egbert Schuurman, called the bill "a historic mistake" and a move that should shame his countrymen.

In recent weeks, the Senate has been bombarded with more than 60,000 letters, mostly opposed to the bill, and an anti-euthanasia group called Cry for Life gathered 25,000 signatures in an effort to halt it.

Although other European nations are weighing "mercy killing" legislation, including Britain, France, Switzerland and Belgium, cries of alarm came from some corners of the Continent.

German Justice Minister Herta Daeubler-Gmelin told the ARD television network that the Dutch legislation was "regrettable," and she urged European medical communities to emphasize therapy and pain relief for those suffering from cancer, AIDS and other degenerative illnesses.

For its part, the Vatican has strongly condemned the Netherlands' acceptance of euthanasia as a legal alternative to natural death.

Often in the world's liberal vanguard, the Dutch also have legalized gay marriage and decriminalized soft drug use. Prostitution is not only legal here but a recognized profession, with state-funded health and retirement benefits.

The Dutch have been struggling for 30 years to find a socially acceptable balance between granting citizens the right to end their own lives and getting so far afield of other developed countries as to become a magnet for "suicide tourism."

Although the law that cleared its last political hurdle in the Senate is clearly designed to offer assisted suicide to terminal cases among the Dutch, critics contend that it has no ironclad protections against foreign visitors establishing doctor-patient relationships here and availing themselves of the world's only legal euthanasia services.

An Australian doctor, Philip Nitschke, told Dutch Radio last week that he was planning to buy a Dutch-registered ship and establish an offshore suicide clinic in international waters outside his home near Darwin. Australia's Northern Territory legalized assisted suicide in 1996, and Nitschke is the only doctor there known to have administered lethal assistance to patients before the law was revoked within a year.

The Dutch action could also rekindle debate about the fate of U.S. assisted-suicide advocate Dr. Jack Kevorkian, who was convicted of murder after administering euthanasia on national television. Only Oregon among the 50 U.S. states has legalized euthanasia.

Under the new Dutch law, a patient has to be experiencing irremediable and unbearable suffering, have been informed of other medical options and been advised by at least one other doctor besides the one offering suicide assistance. The statute also recognizes the validity of written requests or living wills leaving the decision up to a physician if the patient becomes too debilitated to make his or her own judgments.

Since 1971, when a physician named Geertruida Postma ended her elderly mother's suffering from a brain hemorrhage with a lethal injection of morphine, Dutch courts have gradually liberalized the conditions under which assisted suicide went unpunished. Landmark cases have included mercy killings involving severely deformed infants and a healthy, 50-year-old woman who had simply tired of life.

Copyright 2001 Los Angeles Times

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National Post; April 11, 2001

Dutch Senators Pass Mercy-Killing Bill

A long-standing practice

Bruce Wallace

Southam News, with files from Reuters, Agence France-Presse

LONDON - Urging dying patients to "trust in God, not the syringe," a small, anguished minority failed to stop the passage of a bill making the Netherlands the first country where terminally sick and suffering patients can legally ask doctors to end their lives.

About 8,000 protesters turned out last night outside the Dutch senate, which voted 46-28 to give its blessing to the euthanasia bill. Opponents waved petitions with about 60,000 signatures, but nationwide polls have shown 85% of Dutch citizens favour legalizing mercy killings.

The Dutch senate's approval last night ensures the long-standing tacit Dutch practice of doctor- assisted suicide will be legal under controlled conditions.

THE BILL WILL NOT GO INTO FORCE UNTIL THE LOWER HOUSE FORMALLY APPROVES IT, WHICH IS NOT EXPECTED TO HAPPEN UNTIL THE FALL.

Its passage closes more than a year of political debate between supporters who contend "the right to life should not be an obligation to life," and critics who argue sanctioning suicide marks a descent into legalized immorality.

But it will change little in the way doctors and patients have operated in the Netherlands since the country's Supreme Court declared voluntary suicides to be acceptable in 1984. It is estimated almost half of Dutch physicians have helped at least one patient end his or her life.

"This law will remove uncertainty for patients and for doctors," Els Borst, the Dutch Health Minister, told the senators.

Under the new law, patients who choose euthanasia must be in "unbearable pain," although their suffering can be either physical or mental. They must also repeatedly and voluntarily express a will to die while of sound mind. The wish can be transmitted in a previously written declaration.

Yet the legislation has still sparked fears of death tourism -- people travelling to the Netherlands for help in ending their lives.

While it has no specific safeguards against this, the strict criteria Dutch doctors must follow insist on a close doctor-patient relationship, effectively preventing foreigners from getting death on demand. Patients must be Dutch residents and have sought a second medical opinion about their conditions. And doctors are prohibited from suggesting assisted suicide as an option.

As they do now, doctors will have to present each potential case to a medical board for authorization to proceed with the mercy killing. They have always been required to inform public prosecutors of impending cases but, as long as jail sentences of up to 12 years were on the books, many doctors balked at disclosure.

The result was many assisted suicides occurred in the medical shadows, with research suggesting as many as two-thirds of all cases were never reported.

A study published in the British Medical Journal concluded one in five Dutch acts of euthanasia in 1995 was done without the patient's explicit permission. Another 1995 study of 649 assisted suicides showed more than one in five did not go smoothly. In some cases, there was additional suffering, and 16% of the time the medication was not fatal.

Dutch lawmakers contend that removing fears of criminal prosecution will ensure the practice is done according to rules.

The government had to back away from one clause that would have allowed children as young as 12 to ask for permission to die.

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Dutch Hope Euthanasia Law Will Prompt Debate

THE HAGUE (Reuters, April 10) - Policymakers and pro-euthanasia groups in the Netherlands voiced the hope that Tuesday's landmark decision to legalize mercy-killing will encourage discussion on the controversial issue elsewhere

The country's upper house of parliament defied thousands of protesters and voted by a clear majority Tuesday to legalize euthanasia, the first country in the world to do so, bringing into law a practice that has been tolerated here for over two decades.

Demonstrators turned out in force earlier Tuesday to register their opposition to the bill, but most had headed home by the time of the vote -- seen as a formality after the lower house overwhelmingly approved the bill last November -- was taken.

"I hope other governments will find the courage to enter into similar debate,'' said Health Minister Els Borst after the senate voted 46-28 to make euthanasia legal.

At present only Belgium has agreed on a draft law to legalize the practice, subject to parliamentary approval. The U.S. State of Oregon allows physician-assisted suicide.

"I feel glad because after 27 years we have finally achieved what we have been campaigning for,'' Rob Jonquiere, managing director of the Dutch Voluntary Euthanasia Society (DVES), told Reuters after the vote.

"But I feel sympathetic toward our sister organizations in other countries because I know they are campaigning as hard. I hope this will be a great support to them,'' he added.

FIRST REACTION FROM ABROAD NEGATIVE

Early reaction from abroad, however, was negative.

Russian Health Minister, Yuri Shevchenko, interviewed by RTR state television, said the law would be wide open to abuse. "Imagine an ill, old man induced to die with his belongings and small apartment taken from him. This is a great sin and we must not allow it,'' he said.

The Illinois-based "Not Dead Yet,'' organization, a U.S. disability rights group, also condemned the action. "The Dutch experience with euthanasia is best described as one of increasing carelessness and callousness over the years,'' it said in a statement.

An influential Roman Catholic bishop in Poland also spoke against the new law. "Euthanasia allowed in one sphere.., can slip out of control and embrace other groups of people -- those unwanted and disabled,'' said Bishop Tadeusz Pieronek, former secretary general of Poland's episcopate.

The Dutch believe legalizing euthanasia will clear up a fuzzy area of law which has left open the possibility of doctors being prosecuted for murder. Doctors will still face prosecution if they fail to follow strict rules. The new law insists adult patients must have made a voluntary, well-considered and lasting request to die, that they must face a future of unbearable suffering and that there must be no reasonable alternative. A second doctor must be consulted and life must be ended in a medically appropriate way.

"It must be stressed how careful this whole procedure is,'' said Nicoline van den Broek Lamen Trip, leader of the liberal VVD party in the Senate which supported the bill.

The Netherlands has a history of tolerance. It recently became the first country to allow gay couples to legally marry and adopt children.

Jacob Kohnstamm, president of the DVES, said prior to the upper house ruling that he had received thousands of supportive letters and e-mails from as far afield as Britain, France, Belgium, Australia and the United States. "Someone has to be first. There's nothing to be proud of and nothing to be ashamed of... Within 25 years, most countries will have a euthanasia law,'' he said.

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from The Age; Thursday April 12

Death law may attract travellers

By BRETT FOLEY and KERRY TAYLOR

Australians could travel to the Netherlands to use new euthanasia laws to end their lives, Phillip Nitschke said yesterday.

His comments came after the Dutch Senate voted to legalise euthanasia, making the Netherlands the first country in the world to permit mercy killing.

The vote, recognising a practice that has been tolerated in the Netherlands for more than two decades, was seen as a formality after the lower house of parliament overwhelmingly approved the bill in November.

Dr Nitschke said he already had inquiries about using the law, but he was still examining the legislation, including how long people would be expected to live in the Netherlands to be eligible.

Welcoming the decision yesterday, Greens Senator Bob Brown said he intended to introduce a private member's bill after the federal electio to overturn the 1997 legislation that blocked the Northern Territory's euthanasia laws.

"I believe a new vote on that in the next parliament would see a reversal," he said.

Dr Nitschke said he intended to establish a network of Dutch doctors and specialists for Australians to contact.

"Obviously you've got to be able to demonstrate that you're eligible, so you've obviously got to find a treating doctor and go through the procedures which are necessary to establish that," he said.

Dr Nitschke said although the Dutch legislation removed a hurdle for him to register a "death ship" to sail international waters providing voluntary euthanasia services, the concept was still a long way from reality.

He said he would commission an international law expert to provide an opinion on such a scheme. The ship would be Dutch-registered and could anchor in international waters off the Australian coast.

The Victorian President of the Voluntary Euthanasia Society, Rodney Syme, said he hoped the decision would show Australian politicians that legislation was workable.

Dr Syme said the legislation was all the more valid because the Dutch had debated it for 25 years.

"Government surveys have showed there is about 90 per cent public support for this in Holland and this should send a message to governments in Australia that there can be effective legislation with minimal abuse," he said.

Dy Syme said it was unlikely that Australians would be able to use the Netherlands law because of the likely need to show a relationship with a doctor there.

He said the "death ship" was not practical due to the cost and the desire of most people to die at home.

Senator Brown agreed. "We as legislators have to tackle it and have to come in line with public feeling on this," he said. "It's not a case of saying to people how they should die, it's a case of allowing people to make that decision for themselves under very strict circumstances." with AAP

This story was found at: http://www.theage.com.au/news/2001/04/12/FFXMGHLYDLC.html

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NEW YORK TIMES (April 12, 2001)

Horror Expressed in Germany Over Dutch Euthanasia

By ROGER COHEN

BERLIN, April 11 - Cardinal Karl Lehmann, the chairman of the conference of Germany's Roman Catholic bishops, today accused the Netherlands of adopting a "culture of death" by becoming the first country to legalize mercy killing and assisted suicide.

The vehement statement from the cardinal, who said it was "inconceivable" that Dutch doctors would "deliver sick patients to their deaths rather than help them through a difficult situation," formed part of a fierce German reaction to the euthanasia law approved on Tuesday by the Dutch Senate.

Front-page newspaper editorials, statements from ministers and criticism from doctors all took the view that, in the words of George Paul Hefty in the Frankfurter Allgemeine Zeitung, the foremost conservative daily, the Dutch had "breached a dike" with dangerous consequences. The extent of the reaction, far greater than in any other European country, seemed to reflect the enduring unease over euthanasia in a country that tried it under Hitler.

Between 1939 and 1941, using gassing in many cases, the Nazis proceeded with the clandestine elimination of about 100,000 men, women and children who were

physically or mentally handicapped. The aim was to improve what they called the Aryan race by eradicating those who doctors decided had congenital defects.

Referring to these practices in its criticism of the Dutch law, Die Welt, a daily, noted today that under Hitler: "The government thugs that went into institutions for the handicapped to select who was unworthy for life were very careful not to broadcast their intentions. At some level, the old scruples linked to the commandment against killing were present." It continued, "The scandal in The Hague is that a Parliament has imposed a state norm in place of the freedom to uphold such scruples."

Under the new Dutch law, which formalizes what has become common practice in the Netherlands over many years, terminally ill individuals enduring "lasting and unbearable suffering" may ask their doctor to die. If the doctor determines that euthanasia is the best available solution, and a second independent doctor wh is also a trained consultant agrees, then the mercy killing may proceed.

It is widely estimated that about 3,500 people a year have died in this way in the Netherlands over the past decade. In about 85 percent of cases, the deaths occur at home, usually through lethal doses of barbiturates given by family doctors.

Under the law, a child must be at least 12 before requesting death and must then have parental approval. At the ages of 16 and 17, parents must be informed but no longer have the right to decide. Once the age of 18 is reached, a patient is considered to have attained an

adult's right to make such a decision.

"We have a good law at last," said Rob Jonquiere, a retired family doctor in the Netherlands who heads the Dutch Association for Voluntary Euthanasia. "The Germans have a war trauma and to compare our euthanasia law with what happened in the German past is unacceptable because these methods have nothing to do with each other."

There is no question that the Dutch law, with its basis in the patient's initial request to die, has nothing in common with physicians' selection of those deemed unfit to live in the Third Reich.

But German doctors seemed unanimous today in seeing sinister trends behind the Dutch law. Dr. Stephan Sahm, who treats people with cancer in Wiesbaden, argued i the Frankfurter Allgemeine Zeitung that research suggested that many deaths every year in the Netherlands involved "life-ending actions without explicit request." "The process has gained its own dynamics and logic, which is nothing short of merciless," Dr. Sahm wrote.

"Where continuing to live is only one of two legal options, everyone who burdens others with his or her continued existence is held accountable."

"Everyone has the right to a dignified death," said Jörg-Dietrich Hoppe, the president of a leading association of German doctors, "but nobody has the right to be killed. The dangers of abuse are too great."

Suggestions of abuse or of a slippery slope to eve wider use of euthanasia have caused concern in the Netherlands recently. The case last year of a doctor who helped Edward Brongersma, a former senator, die because he felt he was living a "pointless and empt existence" received wide attention. The doctor was acquitted, though Mr. Brongersma had no serious physical or psychological illness.

"If a person is dying in this country," said Peter Huurman, a leading Dutch opponent of euthanasia, "he or she often feels some pressure to consider assisted death from the attitude of doctors and nurses. That is one reason I oppose the law. The other is religious: life is sacred."

But Mr. Jonquiere, who helped two patients to die when he was a doctor before joining the movement for voluntary euthanasia, said a vast majority of Dutch people took the view that "they should control their lives rather than placing their lives in the hands of God." Surveys suggest more than 80 percent of Dutch citizens support the law.

Mr. Jonquiere also argued that the excellence of Dutch health care - everyone has health insurance - ensured that any decision to die is only taken after the best possible treatment "In the United States, where so man people are not insured," he said, "you would not have that guarantee and so you could not defend such a law."

In the United States, Oregon allows assisted suicide i some cases. In Europe, Belgium has a bill before Parliament that would partly decriminalize euthanasia and has taken a broadly sympathetic view of the Dutch decision. Elsewhere, Polish, Austrian and Italian churchmen all spoke out against the Dutch law.

But nowhere was the reaction as virulent as in Germany where so- called bio-politics are currently under intense review. Chancellor Gerhard Schröder said recently that "We agree on what we do not want: the cloned, optimized, genetically selected human being." But he has cautiously left the door open to research o cloning and embryo diagnostics, while ruling out euthanasia.

"This is a catastrophe on moral and social grounds," said Eugene Brysch, the managing director of Germany's main hospice foundation. "Some people in Holland have forgotten German history. Such programs can be misused."

Herta Däubler-Gmelin, the justice minister, said German would shun euthanasia to focus on ensuring the terminally ill "die in dignity and without suffering."

But as in many things in Germany, there appeared to be some distance between official views, always mindful of the past, and public opinion. A survey published today showed that 64 percent of those in western Germany and 80 percent of those in eastern Germany felt a critically ill patient should have the right to ask a doctor to die.

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