Netherlands OKs Assisted Suicide

AMSTERDAM —  In what was both feared and celebrated as a morally groundbreaking decision, the Dutch Senate on Tuesday enshrined in law a terminally ill patient’s right to suicide and a doctor’s immunity from prosecution for assisting.

The decision, which makes the Netherlands the first country to fully legalize euthanasia, was three decades in the making and stirred an eleventh-hour outbreak of religious and conservative opposition. But it had the support of nearly 90% of Dutch citizens as a humane alternative to a painful and undignified death.

Euthanasia has been tolerated here for years, but the majority of citizens and health care professionals wanted a legal framework to protect physicians deterred from ending the suffering of patients by fear of punishment. Until now, assisting in the death of a person was a criminal offense punishable by as much as 12 years in prison, although no one has served time for administering euthanasia since the 1970s.

“This law will remove the uncertainty for patients and for doctors,” Health Minister Els Borst told the Senate before its 46-28 decision to approve a bill endorsed by the lower house of parliament in November. The law will take effect as soon as it is signed by Queen Beatrix and published in official journals--technicalities expected to take two weeks.

Justice Minister Benk Korthals also hailed the legislation as an end to the legal limbo in which doctors have found themselves in a society that so clearly supported the right to assisted suicide but with a penal code that didn’t.

The Senate action culminated a 27-year campaign by the Dutch Voluntary Euthanasia Society, which praised the legislature’s action as a courageous step in ensuring individual rights.

“This is an important and sensitive decision, and concerns about abuse are unfounded,” said the society’s managing director, Rob Jonquiere. “Abuse is only possible when there is no legal framework, which is the problem we resolved today.”

“Someone has to be first. There is nothing to be proud of or to be ashamed of,” said Jacob Kohnstamm, the euthanasia society’s president and spokesman for the moderate D66 political party, which supported the legislation.

Outside the Senate building in The Hague, though, several thousand demonstrators hoisted placards denouncing euthanasia as “murder” and “Nazi morality.”

“It is dangerous and unworthy for a civilized society if doctors are allowed to kill. It could put people under pressure to choose death,” warned Kars Veling, a senator from the Christian Union party, which opposed the legislation. Another party member, Egbert Schuurman, called the bill “a historic mistake” and a move that should shame his countrymen.

In recent weeks, the Senate has been bombarded with more than 60,000 letters, mostly opposed to the bill, and an anti-euthanasia group called Cry for Life gathered 25,000 signatures in an effort to halt it.

Although other European nations are weighing “mercy killing” legislation, including Britain, France, Switzerland and Belgium, cries of alarm came from some corners of the Continent.

German Justice Minister Herta Daeubler-Gmelin told the ARD television network that the Dutch legislation was “regrettable,” and she urged European medical communities to emphasize therapy and pain relief for those suffering from cancer, AIDS and other degenerative illnesses.

For its part, the Vatican has strongly condemned the Netherlands’ acceptance of euthanasia as a legal alternative to natural death.

Often in the world’s liberal vanguard, the Dutch also have legalized gay marriage and decriminalized soft drug use. Prostitution is not only legal here but a recognized profession, with state-funded health and retirement benefits.

The Dutch have been struggling for 30 years to find a socially acceptable balance between granting citizens the right to end their own lives and getting so far afield of other developed countries as to become a magnet for “suicide tourism.”

Although the law that cleared its last political hurdle in the Senate is clearly designed to offer assisted suicide to terminal cases among the Dutch, critics contend that it has no ironclad protections against foreign visitors establishing doctor-patient relationships here and availing themselves of the world’s only legal euthanasia services.

An Australian doctor, Philip Nitschke, told Dutch Radio last week that he was planning to buy a Dutch-registered ship and establish an offshore suicide clinic in international waters outside his home near Darwin. Australia’s Northern Territory legalized assisted suicide in 1996, and Nitschke is the only doctor there known to have administered lethal assistance to patients before the law was revoked within a year.

The Dutch action could also rekindle debate about the fate of U.S. assisted-suicide advocate Dr. Jack Kevorkian, who was convicted of murder after administering euthanasia on national television. Only Oregon among the 50 U.S. states has legalized euthanasia.

Under the new Dutch law, a patient has to be experiencing irremediable and unbearable suffering, have been informed of other medical options and been advised by at least one other doctor besides the one offering suicide assistance. The statute also recognizes the validity of written requests or living wills leaving the decision up to a physician if the patient becomes too debilitated to make his or her own judgments.

Since 1971, when a physician named Geertruida Postma ended her elderly mother’s suffering from a brain hemorrhage with a lethal injection of morphine, Dutch courts have gradually liberalized the conditions under which assisted suicide went unpunished. Landmark cases have included mercy killings involving severely deformed infants and a healthy, 50-year-old woman who had simply tired of life.