The following data are taken from the annual report of the Regional Euthanasia Review Committees (RTEs). These figures do not include cases of clandestine euthanasia and palliative sedation, which are in fact euthanasia. [1]. The Centre of Excellence on Euthanasia is located in a leafy suburb of The Hague and is the only one of its kind to provide information, support to doctors and offer euthanasia as end-of-life care, which was legalized worldwide for the first time on 1 April 2002 in the Netherlands. In 2002, the first year of the Act, 1,882 cases of euthanasia were reported. By 2012, that number had risen to 4,188; and in 2016, it reached 6,091 cases. In 10 years, the number of euthanasia cases has doubled and tripled in 15 years. In comparison, the population of the Netherlands grew by only 4% between 2002 and 2016. Euthanasia and assisted suicide are only legal if the criteria of the Dutch law on termination of life on request and assisted suicide (review procedure) are fully met. Only then is the doctor concerned protected from criminal prosecution.

Requests for euthanasia often come from patients who experience unbearable suffering with no prospect of improvement. Your request must be made seriously and with conviction. They see euthanasia as the only way out. However, patients do not have an absolute right to euthanasia and physicians do not have an absolute duty to perform it. The Euthanasia Review Committee has updated its guidelines in response to the case of a former nursing home physician, Marinou Arends, who was prosecuted and acquitted of murder after adding a sedative to her 74-year-old patient`s coffee before she administered a lethal injection. The 3rd five-year evaluation report (2012-2016) of the Dutch law, published in July 2017, which examined death certificates, showed that deaths due to «deep and continuous sedation at death» increased by 8.2% in 2005 to 18% in 2015. This sharp increase highlights the need to better understand whether this technique is palliative care or euthanasia. Nor can doctors be forced to euthanize. On three occasions in 2014, the end-of-life clinic was accused by regional review committees of irregularities in its application files. Nevertheless, this clinic has continued to develop its activities shamelessly. In 2015, two cases of euthanasia were classified as non-compliant with legal requirements.

Despite this, the end-of-life clinic responsible for the procedure was not prosecuted. The KNMG association, which brings together 53,000 doctors, denounces these «mobile teams» who do not know patients well enough to be able to assess their condition: «We are not against euthanasia if there is no other alternative. But euthanasia is a complex process that follows long-term treatment and is based on a relationship of trust with the patient. We must have a holistic approach to the treatment of the patient, especially to assess whether there is an alternative to euthanasia: we seriously doubt that this can be done by a doctor whose sole purpose is to perform euthanasia. 27 November 1984: The Dutch Supreme Court introduces into case law the aspect of force majeure that a doctor can invoke if he has resorted to euthanasia but has acted conscientiously and in accordance with medical ethics. In 2014, Belgium became the first country to allow voluntary euthanasia of children if they are terminally ill and in great pain and have parental consent. The Netherlands quickly introduced the same regime for children over 12 years of age. Pollard, Dr.

Brian. «Current law on euthanasia in the Netherlands.» New South Wales website (2003). Some people feel that they would like euthanasia to be practiced if they were ever in a certain situation that they would now consider unbearable and with no prospect of improvement. Your best course of action is to discuss the situation you are considering with your GP and issue a written instruction about these circumstances. These living wills define the exact circumstances in which the patients concerned wish euthanasia. The document is an invitation to the physician and must contain a clear and unambiguous expression of the patient`s wishes. In 2002, five regional review committees were established to assess euthanasia cases and verify that physicians are acting in accordance with due diligence criteria. They report annually on euthanasia in their respective provinces. It is known that the rate of reporting of euthanasia by doctors has been low since 1990 and, even after the introduction of special regulations to improve this phenomenon, it is still reported in less than half of the actual cases. Doctors often falsify death certificates after euthanasia to make it appear that the death is due to natural causes, even if this falsification is itself a criminal offense. Some doctors have said they will never report euthanasia no matter what the government decides.

While some denounce violations of the law, others want to expand the conditions of access to euthanasia and practices. Parliament is under pressure to allow assisted suicide to people over 70 who request it, for no reason other than their age and «tired of life.» At the beginning of 2010, for example, the association «Aus freier Willen» (Uit vrije will) organised a citizens` initiative petition to force a parliamentary debate. A draft law presented by the government in October 2016 is currently under consideration. Late 90s: Parliamentary debates are held to «legally» decriminalize euthanasia and assisted suicide, leading to the law of April 12, 2001. According to the official report of the regional euthanasia review committees in 2016, physicians at the end-of-life clinic performed approximately 400 euthanasia cases, compared to 107 in 2013. They gladly accept the most borderline and «complicated» cases that other doctors do not necessarily think are justified, and yet this clinic does not seem to notice being reprimanded by the supervisory board or the judiciary (see below). Unlike most other jurisdictions where medically facilitated deaths are legal, euthanasia law in the Netherlands does not require a patient to be close to death. The guidelines of the law are few and general. In addition to obtaining formal consent – a patient`s request must be «informed» and «voluntary and thoughtful» – the physician must be «convinced» that two conditions are met: the patient has «unbearable suffering, with no prospect of improvement» and there is «no reasonable alternative» to remedy it. The doctor must use euthanasia drugs correctly and consult an independent doctor – although he is not bound by the advice of this external consultant. Indeed, as long as the patient is at least 16 years old, the consent of a person other than that of the patient is mandatory. (Parents of 16- and 17-year-olds participate in the discussion, but their permission is not required.

Patients over the age of 12 may request euthanasia with parental consent. In approximately 10 cases since 2002, children aged 12 to 17 have been euthanized; As far as I know, everyone was for physical illness.) In 2016, there were 16 cases of euthanasia per day in this country for a population of 16.8 million; This represents 4% of all deaths per year. With respect to Article 3, it should be noted that euthanasia, as is currently the case, is not punishable even if it is performed by a physician who followed only some or perhaps none of the guidelines and then falsified the death certificate after euthanasia to give the appearance that the death was due to natural causes. In 2010, 3,136 cases were reported in which a physician assisted in the death of a patient. In the categorization, there were 2,910 cases of «end of life on demand», 182 cases of assisted suicide, and in 44 cases, it was a combination. The evaluation commissions decided that in 9 cases the procedure was not based on the protocol and referred the cases to the Public Prosecutor`s Office and the Health Inspectorate. [10] The number of reported cases has increased by 8% each year. By 2017, the number of reported euthanasia cases had increased to 6,585; 99.8% of them are carried out with care.

[11] The reason for this increase is unclear. [10] In 2010, the figure was 4,050 and, according to a study by the Vrije Universiteit, Utrecht University Hospital and Statistics Netherlands, published in The Lancet, this was no more than before the entry into force of the «Act on Termination of Life on Demand and Assisted Suicide (Review Procedures)» in 2002; [6] And the study concluded that the law did not lead to more cases of euthanasia and assisted suicide on request. [7] The new code states that in cases where a patient has advanced dementia, «it is not necessary for the physician to agree with the patient on the timing or manner of euthanasia.» The law explicitly states that the patient`s request must be voluntary and well thought out. Therefore, it is problematic to grant euthanasia to patients with psychiatric disorders or dementia. For a decision as irreversible as euthanasia, the question posed by free choice applies until the last moment. For patients with mental health issues, it is even more difficult to express free will. But euthanasia is not uncommon in these situations. The reference to a living will (a written document requesting euthanasia in cases where the person can no longer give informed consent) is common to justify euthanasia in dementia.

In the Netherlands, euthanasia is governed by the Act on End of Life on Request and Assisted Suicide (Review Procedure)», adopted in 2001[1] and entered into force in 2002.