 | Agnes van der Heide Full professor - Erasmus MC, dept. of Public Health |
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02.02.2015-27.02.2015
The societal impact of allowing physician-assistance in dying: experiences from the Netherlands after the adoption of the euthanasia law
The objective om my project is to analyze the societal impact of the euthanasia law in the Netherlands. In this country, euthanasia is defined as the administering of lethal medication by a physician on the patient’s explicit request. In physician-assisted suicide the patient self-administers lethal medication that was prescribed by a physician. The Dutch Law on Termination of life upon the request of the patient and assistance in suicide came into effect in 2002, after about three decades of debate, and establishment of criteria of due care and a reporting system. Since 1990 this debate has been accompanied by empirical research to get insight in the practice of physician involvement in the hastening of death. In 2010 the most recent nationwide study was performed. It showed that over 20 years there has been a gradual increase in the frequency of euthanasia, but that the practice remains largely confined to patients with terminal cancer. Recent debates about physician-assisted dying in the Netherlands focus on whether this practice should also be an option for older patients without serious medical diseases or for incompetent patients. My goal in this project is to analyze the debate on the scope of the euthanasia law after its adoption in 2002, and its impact on societal attitudes towards death and dying, towards disease and suffering, and towards physicians’ versus patients’ responsibilities in end-of-life care. I will use empirical data from the 5-yearly nationwide studies on end-of-life decision making practices and data from other studies on practices and attitudes in this area that have been published during the last decade. Further, I will make an analysis of the debate in public media such as national newspapers. Finally, preliminary results of my analysis will be discussed with Dr Steffen Eychmuller from Bern University, who is very much involved in end-of-life care in Switzerland. Switzerland is an interesting country for comparison, because since the early 19th century, the Swiss Penal Code has allowed assistance in suicide provided that the person seeking assistance has decisional capacity and the person assisting is not motivated by reasons of self-interest since the early nineteenth century. Assistance in suicide is mostly provided by right-to-die organizations, who are obliged to account for their practices before the legal authorities.
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