A new study sheds new light on euthanasia in the Netherlands, the first country to legalize it for terminally ill people, finding that nearly one in eight adult patients who requested mercy killings decided not to go through with it. Nearly half of the euthanasia requests were carried out.
The study comes at a time of heightened scrutiny of euthanasia -- especially in the Netherlands, where officials acknowledged last year that they had carried out mercy killings of terminally ill newborns.
Belgium has since enacted a euthanasia law similar to the Netherlands. In the US, Oregon is alone in allowing physician-assisted suicide, but its law is expected to be argued before the US Supreme Court this fall.
broad survey
The study, appearing in Monday's Archives of Internal Medicine, consists of a survey completed by 3,614 Dutch general practitioners who were asked to describe requests for euthanasia they received during the previous year.
While more than half the doctors had not received a request, almost 20 percent received more than one. Of those 2,658 requests, 44 percent resulted in euthanasia. In 13 percent of the cases, the request was granted but the patient died before the act; in another 13 percent the patient died before the decision-making process was completed. In 12 percent, the physician refused the request. In another 13 percent, patients changed their minds. In the remaining cases, the decision was still ongoing at the time of the survey, or the doctor did not detail the reason euthanasia was not performed.
not medical
Project leader Bregje Onwuteaka-Philipsen said she was surprised that "the most important reasons for doing the request are not strictly medical." The survey asked physicians the reasons that patients in their most recent euthanasia case sought help in ending their own lives, with the most frequent being pointless suffering, loss of dignity and weakness.
In cases in which doctors denied the requests, the most common reasons were not wanting to be a burden on their family, tired of living and depression.
The 13 percent of patients who decided ultimately not to pursue euthanasia demonstrates "it is really very important to keep asking the patient [until the moment of the actual administration] whether this is what he or she wants," Onwuteaka-Philipsen wrote in an e-mail.
newborn euthanizing
The study does not mention the proposed guidelines for mercy killings of terminally ill newborns designed by officials at Groningen Academic Hospital. In November, officials there revealed they had already begun carrying out such procedures, euthanizing four severely ill newborns in 2003.
A Dutch government proposal on guidelines involving infants is expected to be released this fall.
The Netherlands has a long history on the issue, where for decades euthanasia was outlawed but widely practiced and rarely prosecuted.
Under a law that took effect in 2002, euthanasia is restricted to terminal patients suffering unbearable pain with no hope of improvement, and who request to die when they are of sound mind. Each case is reviewed by a panel of medical experts.
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