Sanctioned Euthanasia: Lessons from Abroad for Patients, Does Dutch Example Imply Power or Pressure?

Article excerpt

If Jack Kevorkian were in the Netherlands, he probably wouldn't be nearly so notorious as he is in the United States. There, helping people take their own lives - which the Michigan pathologist admits to having done some 120 times in this country - is officially sanctioned.

But does the Dutch experience with physician-assisted suicide and euthanasia provide any lessons for a country grappling with the ethical and legal issues surrounding Dr. Kevorkian?

Both sides in the debate cite the record there to buttress their case. Supporters of carefully prescribed laws allowing assisted suicide, like the one here in Oregon, say there has been no rush to hasten death in the Netherlands. Between 2 percent and 3 percent of the cases involve an active role by doctors - usually within a few weeks of when patients are expected to die. And while helping someone take his or her own life remains technically illegal there, guidelines and reporting procedures approved by legislators and upheld by Dutch courts have satisfied prosecutors and the public. Opinion polls show high support, and only rarely have doctors been charged in such cases. In fact, Oregon's landmark law is far more restrictive than Dutch practice. It applies only to mentally competent adults who declare their intentions in writing, are diagnosed as terminally ill, and take the prescribed drug themselves orally after a waiting period. Oregon prohibits "lethal injec- tion, mercy killing, or active euthanasia." But the recent broadcast of a video showing Kevorkian injecting a man with a lethal dose of a drug has galvanized opposition to such procedures, even though the man and his family had requested it. Failure to prosecute Kevorkian, they say, would mean a "slippery slope," posing special dangers for vulnerable patients. "At greatest risk are the poor, elderly, disabled, disadvantaged, and others without access to good medical care - for whom the 'choice to die' could become the 'duty to die,' " warns C. Everett Koop, the former US surgeon general. …