One in five Dutch doctors would help physically healthy patients die

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Nel Bolten’s tattoo reads: ‘Do not resuscitate!!! I am 91+’. The Dutch health minister has declared that the tattoo is a legal declaration that gives the 91-year-old the right to self determination to end her life. Image: Getty

By Peter Walker – The Guardian.

Almost one in five Dutch doctors would consider helping someone die even if they had no physical problems but were “tired of living”, according to one of the most comprehensive academic studies of such attitudes.

The research, in which almost 1,500 GPs, geriatric care doctors and clinical specialists answered a detailed, anonymous survey, also found that 2% of them said they had taken part in such euthanasia or assisted suicide without medical grounds for a patient who was suffering, even though this is prohibited under Dutch law.

The paper, published in the Journal of Medical Ethics, also found that 40% of the doctors said it was conceivable they would help someone in the early stages of dementia to die, while 3% had done so. Just over a third said they might also be willing to assist people with a psychiatric disease who wished to end their life.

The Netherlands has one of the world’s more liberal approaches to euthanasia and assisted dying. The practice was in effect decriminalised when doctors were permitted to plead a defence of necessity, arguing that their duty to relieve suffering superseded that to preserve life. This was codified in a 2002 law which lays down six preconditions, crucially that the patient faces “unbearable suffering without prospect of improvement”.

The law does not specify that this suffering must involve a physical illness or condition. However, a subsequent case in the supreme court ruled that in order for a doctor to properly assess the extent of suffering the main cause of this must be medical.

Nonetheless, the study found that 18% of the Dutch doctors would consider helping someone to die without them having any physical affliction if they were “tired of living”. Also, 27%, said they would possibly assist in a death of someone who had a medical condition but not a serious one. The authors concede that the self-selecting nature of the respondents – about 800 doctors were sent the questionnaire but did not return it – could skew the results slightly.

Eva Bolt, at VU University in Amsterdam, who led the study, said doctors seeking to help end the life of someone free from physical problems would be breaking the law. However, she added, this did not mean the 2% who admitted doing so had committed a crime: “It’s hard to say – it’s possible that these are physicians that performed euthanasia years ago, when there was no law, so we can’t say they didn’t abide by the law.”… read more.


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