The practice of euthanasia in the Netherlands.

• Author: van der Sluis, I.

The Practice of Euthanasia in the Netherlands

When people talk of euthanasia, they think of a patient who is so very ill and suffers so much that the doctor gives him a lethal injection. Sometimes, doctors, following their duty to alleviate the sufferings of the dying, act in a way that comes very close to killing their patient. Certainly under the conditions prevailing in hospitals, where treatment is complex, there is not always a sharp line dividing palliation from euthanasia.

Most doctors have accepted these necessities of medical life, at least in countries where they are not working under the continuing threat of malpractice suits. Doctors have not and still do not feel an urgent need to discuss in public, as a major ethical or political issue, the hard cases which, after all, are exceptions.

A New Attitude

Since the growth of the euthanasia and patients' rights movement, however, these and other hard cases have become a hot issue. Fine points of medical casuistry are now the object of discussion in the popular press, and euthanasia is presented as the one and only way out.

But all this is not what euthanasia is really about. The movement in favor of mercy-killing is much more ambitious. It springs from and is part of an entirely new attitude towards life. It is not aiming at some marginal reform of medically manipulated death. If the concept of euthanasia succeeds, it will lead to revolutionary changes in medicine, in health care for persons who are older or disabled, in law, in family life, and in the very way people deal with each other.

This new attitude implies that life is no longer an incomparably precious and unique gift, but a disposable good, something you own like a coat or refrigerator, and that you can throw away if it no longer suits you. In fact, most authors who plead for euthanasia think that far too many lives in the world are not worth living, and should be brought to an end one way or another. People should give up their lives if they become cumbersome to themselves or to others. It is really their duty to do so. For example, S. D. Williams, who was one of the earliest proponents of the cause, published an essay in 1870 in which he asked "[whether] it be not a man's duty to consider others' feelings ...; and to bethink himself whether he ought to condemn those nearest him to witness sufferings which they could find it almost as easy to bear themselves as to see another bear."(1)

It is not difficult to find other examples of this mentality among the classical authors of the movement. The German jurist Jost wrote in 1985: "Therefore, he who is able, in an incurable and painful disease, to escape from life . . . acts according to a right he possesses . . ., frees society from a useless burden, [and] even by his suicide fulfills a duty."(2) Jost proclaims a right to death for everyone whose "value of life," as he calls it, has become "negative."(3) Lunatics should be killed without their consent: a diagnosis that their disease is incurable is sufficient justification.(4) Jost's remark on the gradual extension of the right to die is very candid: "Of course at first, strict limitations must be respected. For example, the right to die of lunatics will only come into consideration later, because consent of the patient is of course lacking, and this circumstance could easily, at least at the beginning of the reform, be a disadvantage.(5)

Haeckel, a famous German biological author of the end of the last century, wanted to kill 200,000 incurable lunatics and mental defectives out of Europe's population of 2 million. In his Lebenswunder, he writes: "What a tremendous sum of pain and grief . . . what losses of property, private and public could be spared, if only people would decide at last to release the absolutely incurable from their unspeakable ills with a dose of morphine."(6)

Even Dr. Killick Millard, the originator of the first euthanasia society in the world, the Voluntary Euthanasia Legalization Society founded in London in October of 1935, though he said he wanted voluntary euthanasia, wrote:

What is needed is a somewhat new orientation of our ideas

concerning life and death. Life is a thing for use, and especially

in the service of others--in that sense it is certainly sacred--but

it is not something to be selfishly clung to after it has

permanently ceased to be useful, and especially if we have become a

burden to others.(7)

Like the British Society, its American counterpart was officially committed to strictly voluntary euthanasia. But less officially, there were hints of other things. According to the New York Times of January 27, 1939, Charles E. Nixdorff, the Society's Treasurer, declared to some of the members present at the first annual meeting, who had protested against this restriction, that the proposals were limited to willing patients only because public opinion was not yet ready to accept the broader principle. However, the Society's goal sanctioned involuntary euthanasia of persons considered to be beyond the help of medical science.(8)

In support of the Voluntary Euthanasia Bill of British Society, Lord Ailywn made this statement in the House of Lords on March 25, 1969:

My Lords, if I wanted any reassurance of my own views in favor

of euthanasia, I got more than enough a few days ago while

visiting an old people's hospital. Rows upon rows of beds, each

holding a human being lying there inert, some sleeping, some

perhaps under sedation, some with their eyes open looking

utterly listless, hopeless, lifeless, in a kind of torpor. One felt

stifled with the all...