Chapter XXX: the society that has embraced euthanasia.

• Author: Fenigsen, Richard
• Position: Other People's Lives: Reflections on Medicine, Ethics, and Euthanasia

In the last three decades euthanasia has become one of the main issues, and the most discussed issue in Dutch public life, politics, and national conscience. Euthanasia is supported by all major Dutch political parties and by a majority of Dutch Catholics, Protestants, and agnostics and has found a way to express and unify important and disparate social moods and tendencies.

The anti-intellectual and anti-technological rebellion in the years after World War II, and the triumphant technological society's certitude that all problems (including death) can and must be solved, met and intertwined in the movement in favor of euthanasia. The movement was begun by people who believe in abolition of all taboos and joined by those observant of the new taboos protecting autonomy and selfishness. The movement in favor of euthanasia succeeded in unifying at the same time the modern abhorrence of death, disease, dependence, and disfigurement, and the new national fascination with death.

People intent on improving the human race by extermination of weaklings form an important current in the movement in favor of euthanasia. They mute their rhetoric to conform with the official platform, but when euthanasia is considered for infants with disabilities, and people who are mentally retarded or demented, or the policy of allowing certain groups to die out is promoted, the supporters of extermination reveal their presence in an unmistakable way.

The supporters of free choice and "the right to die" form an even more important current. This group includes both libertarian intellectuals who proclaim the individual's unlimited right to self-determination and people who simply are afraid of suffering, feel that they have the right to escape it, and want to have the means. The libertarians have shaped the present official platform of the movement.

Active euthanasia has been openly practiced in the Netherlands for over thirty years, a time probably too short to expose all the changes it brings about in society, but long enough to reveal some of the consequences. Indeed, the practice of euthanasia has perceptibly affected the position of the individual in relation to society, society's very nature and purpose, law, government, judicial system, the practice of medicine, family, the expectations of older persons, and the prospects of newborn citizens.

Some knowledge of the Dutch health care and welfare system is needed for a correct understanding of Dutch euthanasia. It is important to realize that among the industrialized nations Holland has developed one of the best, and arguably the best, health care system, and an excellent system of care for older persons and people with disabilities. (548) Practically all of the country's residents have health insurance--money plays no role in a patient's decisions concerning medical treatment. A high percentage of physicians practice family medicine, which makes health care eminently accessible. There are no crowded emergency rooms. Nursing homes and institutions for mentally retarded persons are modern, well equipped, and manned by skilled and dedicated workers.

Does economy influence Dutch euthanasia? Having closely watched the scene of Dutch euthanasia for many years, I am quite certain that the Dutch pro-euthanasia movement, its mainstream, has never been economically motivated. When some defenders of euthanasia assume a no-nonsense attitude putting forward economic arguments, it is felt this is a rationalization serving to conceal motives more difficult to avow.

The Intolerant Majority. In the very open Dutch society an exception is made for euthanasia: The majority does not tolerate dissident views on this issue, and opposing acts are strongly condemned. In numerous articles and declarations those who object to euthanasia have been accused of trying to impose their own views on other people, excluded from the community of reasonable persons, (549) and depicted as fanatics prone to outbursts of rage. (550) When the pediatricians, the surgeons, and the parents denied surgery for duodenal obstruction to a baby with Down syndrome and let the child die, the only person whose conduct was found to be at fault was the family physician who did not agree with the decision and called the district attorney. He was said to have grossly violated the privacy of his patient and of the parents and to have transgressed his duty to preserve professional confidentiality. (551) The nurse who protested against euthanasia of a child with disabilities and, together with her husband, offered to adopt the baby, saw her offer rejected, and received an official reprimand because by involving her husband in the adoption offer she violated professional confidentiality. (552) In the affair of the doctor who killed several residents of a senior citizens' home without their request, consent, or knowledge, a high ranking lawyer, the Board of the Royal Dutch Society of Medicine, and the president of the Dutch Society for Voluntary Euthanasia declared that the person to be blamed was the district court judge who unduly made a criminal of the defendant, and by sentencing the doctor adversely influenced the practice of euthanasia in the country (553) Critics of euthanasia are sued by the Dutch Society for Voluntary Euthanasia; (554) and those opponents of euthanasia who are Jewish are implicitly (555) and explicitly (556) met with the reproach that their personal reminiscences of the Nazi era and the resulting bias disqualify them from pronouncing any judgment on euthanasia. (557) Hostile acts follow, aimed at undercutting the opponents' income and professional existence. A dermatologist in...