Euthanasia and the Netherlands - Part III

Arguments related to Euthanasia

Supporters of euthanasia put emphasis on the principle of autonomy because the state must not do anything to obstruct the exercise which is regarded as a fundamental freedom. The principle of beneficence supports termination of life in the patient’s interest and it imposes the duty to alleviate pain or ease suffering. The principle of the sanctity of life is another supporting ground. Those who are against the euthanasia stressed that the aim of medicine and therefore a doctor’s first duty is to preserve life and that killing a patient directly conflicts with his duty. Another argument is the slippery slope which means that even if euthanasia is perhaps acceptable, legalizing it will inevitably lead to practices that are not. Also it is not possible to know for certain whether the request of the patient was truly voluntary. The worry of slippery slope was counteracted by the fact that Dutch legal developments in the area of non-voluntary termination of life do not seem terribly shocking and there is no reason to suppose that their frequency is increasing or that it is higher in the Netherlands than elsewhere.

Legal Control of Euthanasia in the Netherlands

Legal control by criminal law is the problem and not the solution. The available alternative is to offer more prospect of effective control through non-criminal regulation. The prosecutorial authorities should leave control to civil law and to medical disciplinary law. The basic elements of a non-criminal enforcement regime would be professional protocols, open and transparent decision-making, involvement of other persons than the responsible doctor in the decision-making concerning performance of euthanasia, full record-keeping, marginal control of local assessment by a proactive agency, and backstop formal (non-criminal) sanctions in cases in which informal sanctions are inadequate or ineffective. After the death of the patient the responsible doctor would submit a report of the case to a local professional committee. Only cases of very serior or persistent violation of the applicable requirement would be reported individually to the Medical Inspector and who could decide to issue warning or to initiate disciplinary proceedings.