The first Survey: the incidence of 'euthanasia'
Since the Dutch Supreme Court declared VAE lawful in 1984, a substantial body of empirical data has emerged concerning its practice. Much of this data has helpfully been generated by the Dutch themselves in the form of two major surveys. The first survey examined practice in 1990; the second practice in 1995. This chapter will consider the incidence of VAE and of other forms of intentional life-shortening (in particular NVAE and PE or passive euthanasia) in 1990.
The Dutch coalition government which assumed office in 1989 decided to appoint a commission to report on the 'extent and nature of medical euthanasia practice'.1 A commission under the chairmanship of the Attorney-General, Professor Remmelink, was appointed on 17 January 1990 by the Minister of Justice and the State Secretary for Welfare, Health and Culture and charged to report on the practice by physicians of 'performing an act or omission … to terminate [the] life of a patient, with or without an explicit and serious request of the patient to this end'.2 The Commission asked P. J. van der Maas, Professor of Public Health and Social Medicine at the Erasmus University, to carry out a survey which would produce qualitative and quantitative information. The Commission and Van der Maas agreed that the survey should embrace all medical decisions affecting the end of life so that VAE could be seen within that broader context. Their umbrella term 'Medical Decisions concerning the End of Life' ('MDELs') included 'all decisions by physicians concerning courses of action aimed at hastening the end of life of the patient or courses____________________