Euthanasia approved too quickly, reforms needed: ethicist

Euthanasia Doctors sometimes give in too quickly to the claims of patients that they are suffering unbearably. It can therefore not be ruled out that in the Netherlands euthanasia is granted to people who still had years to live.

This says ethicist Theo Boer (54), who left the Regional Euthanasia Review Committee in September after working there for more than nine years. In those years he evaluated more than 4 thousand cases of euthanasia. Based on that experience Boer concludes that doctors, politicians and review committees should seriously consider reevaluating the euthanasia law.

In the Netherlands 5 review committees asses afterwards whether physicians have complied with the legal due diligence in the performance of euthanasia. According to Boer, professor of Ethics of Care at the Theological University Kampen, that does not always go smoothly.

According to Boer, the catch is in the requirement that the physician must be convinced that the patient is suffering unbearably. Physicians find it difficult to tell their patients that their suffering is not unbearable. "This is understandable, because it is almost inhuman to say."

Boer thinks that this was not considered properly in the creation of the law, which took effect in 2002. In the first years after the introduction Boer had fewer problems with the provision on unbearable suffering because almost only people with a terminal, physical condition were given euthanasia. But now euthanasia is often given to people who still had some time to live.

He therefore wants to add a stronger medical component in the law or in its review. The fact that some conditions may fall by the wayside is, according to Boer, outweighed by the advantages of a more objective criterion. If developments continue in this way, he expects a strong increase in the number of cases of euthanasia because people do not want to be put in a nursing home. He already sees it happening now.

"I think of cases where one of the two gets an acute, terminal condition, and where the care-dependent partner says: 'I don't want to continue without my beloved'. If such a person views admission to a nursing home as unbearable suffering and the doctor agrees, then you can according to the letter of the law find it difficult to make a 'careful' judgement."

Boer advocates for a breathing space in which it is agreed to not take in any more groundbreaking cases. If it were up to him, he would form a committee that will conduct a public and cross-party discussion. This should be about what practice of euthanasia in the Netherlands is most future-proof and safe.