Euthanasia legislation expands to cover terminally ill children under-12 in Netherlands

Doctors will be able to euthanise children between the ages of one and 12 in the Netherlands under the country’s ever-expanding assisted suicide regime.

Deputy Prime Minister Hugo de Jonge, who also serves as the Health Minister, wrote to Dutch politicians this week outlining his plans to amend regulations to allow ‘active life termination’ for terminally ill children ages between one and 12.

Current law

Under the current law, non-voluntary euthanasia is available for Dutch babies who haven’t yet reached their first birthday.

Children between 12 and 15 can be euthanised with the approval of their parents, while those aged over 16 are eligible for euthanasia if they make a considered, voluntary request for it and if their suffering is “unbearable.”

As it stands, there is no euthanasia provision for children between the ages of 1 and 12.

‘Necessary’?

However, that looks set to change with de Jonge claiming a change in regulations is necessary to help prevent children from suffering.  

Despite months of debate and strong opposition from political parties, including his own – the Christian Democratic Appeal party – de Jonge noted in his letter that a parliamentary Bill wouldn’t be needed to introduce euthanasia for one 12 year-olds.

Instead, doctors will be exempt from prosecution if they carry euthanasia on someone in this age range if they do so to end “unbearable suffering”.

In their apparent attempt to circumvent parliamentary procedure, de Jonge says health bosses are working on policy updates alongside the Public Prosecution Service.

Euthanasia on the increase as safeguards are eroded

The Netherlands was the first country in the world to legalise euthanasia when its Termination of Life on Request and Assisted Suicide (Review Procedures) Act came into effect in 2002.

Since its introduction, the legislation has become more extreme and safeguards have been eroded.

Last year, 6,361 individuals lost their lives to euthanasia in the Netherlands – equating to 4% of the country’s total deaths. In addition, the Netherlands’ only euthanasia clinic revealed that it had seen a 22% increase in requests from people seeking assistance to end their lives in 2019, compared to 2018.

In June, a Dutch doctor, who was cleared of murder for euthanising a vulnerable woman with dementia, waived her anonymity to declare she did the “right thing”, even though her patient said “no” three times.

In an interview with Dutch current affairs programme Nieuwsuur, Marinou Arends attempted to justify her actions saying they were “for the best”.

Her comments come after a 2019 district court ruling in the Hague stating that doctors in the Netherlands can no longer be prosecuted for carrying out euthanasia on dementia patients who have previously given written consent.

Previously, those with dementia would need to reconfirm their earlier request.

Expanding euthanasia law

In July, a Dutch MP introduced a controversial Bill that would allow healthy people to have an assisted suicide if they feel their life is ‘complete’.

Pia Dijkstra, Foreign Minister for the four-party coalition Government and medical ethics lead for coalition party D66, submitted a Bill that would allow healthy individuals over the age of 75 to seek euthanasia if they have had “a strong death wish” for at least two months.

Outlining their opposition to similar proposals in 2017, the KNMG Royal Dutch Medical Association believes it could have the undesirable effect of stigmatising the aged population.

The medical association said that the government should invest in measures to make sure the elderly do not feel their lives are pointless, over the option of an early death.

Healthy over 75s targeted in Dutch assisted suicide law expansion

A Dutch MP has tabled a controversial Bill that would allow healthy people to have an assisted suicide if they feel their life is ‘complete’.

Pia Dijkstra, Foreign Minister for the four-party coalition Government and medical ethics lead for coalition party D66, submitted the proposed bill last week.

It would allow healthy individuals over 75-years-old who have “a strong death wish” for at least two months to seek the assistance of an ‘end-of-life supervisor’ to die.

The Bill will now go to the Raad van State judicial advisory committee for review – a process which will take three to six months – before being scheduled for a debate and vote.

It will then need to win a majority vote in the House of Representatives before being passed to the Senate for a debate and vote.

‘Completely unacceptable’

According to Dutch News, the proposals are likely to stoke conflict in the Government, with two of the coalitions four parties being radically opposed to any further expansion of assisted suicide legislation.  

The Christian Union party finds the proposal completely unacceptable and says its timing, during the coronavirus pandemic, is insensitive.

The party leader, Gert-Jan Segers, said: “I find it extraordinarily painful that at a time when old people feel extra vulnerable, D66 submits a proposal that we know will cause many of them increased insecurity and worry.”

Christian Union Party member Carla Dik-Faber added: “D66 chooses against all advice to come up with a law that is literally life-threatening… Instead of a plan to address the concerns, the worrying and needs that the elderly may suffer from, says D66: here you have a pill. I find that very, very bitter.”

Outlining his opposition to the proposals, CDA leader and health minister, Hugo de Jonge, made an appeal to tackle issues of loneliness and social problems faced by the elderly.

In a parliamentary briefing he said: “It is our task to make every effort to ensure that these people find the meaning of life and meaning in life again.”

Outlining their opposition to similar proposals in 2017, the KNMG Royal Dutch Medical Association believe it could have the undesirable effect of stigmatising the aged population.

The medical association said that the government should invest in measures to make sure the elderly do not feel their lives are pointless, over the option of an early death.

Euthanasia on the increase

The Netherlands’ only euthanasia clinic recently revealed that it had seen a 22% increase in requests from people seeking assistance to end their lives last year compared to 2018.

Last month, a Dutch doctor, who was cleared of murder for euthanising a vulnerable woman with dementia, waived her anonymity to declare she did the “right thing”, even though her patient said “no” three times.

In an interview with Dutch current affairs programme Nieuwsuur, Marinou Arends attempted to justify her actions saying they were “for the best”.

Her comments come after a 2019 district court ruling in the Hague stating that doctors in the Netherlands can no longer be prosecuted for carrying out euthanasia on dementia patients who have previously given written consent.

Previously, those with dementia would need to reconfirm their earlier request.

Doctor defends euthanasia on vulnerable patient who said ‘no’ three times

A doctor cleared of murder for euthanising a vulnerable woman with dementia has waived her anonymity to declare she did the “right thing”, even though her patient said “no” three times. 

In an interview with Dutch current affairs programme Nieuwsuur, Marinou Arends attempted to justify her actions saying they were “for the best”.

On April 22, 2016, the now-retired doctor euthanised a 74-year-old woman with Alzheimer’s who had been admitted to Mariahoeve care home in The Hague seven weeks before.

The vulnerable patient had earlier written a directive asking for euthanasia in the event that she was admitted to a nursing home due to dementia, but indicated she wanted to determine when “the time was right.” 

But, once in the nursing home, she gave “mixed signals” about wanting to die.

And in the days leading up to her death, the patient affirmed her desire to live, saying, “I don’t want to die,” on several occasions. 

Arends asked the woman three times if she wanted euthanasia, but on each occasion, she answered that she did not.

“I couldn’t get this confirmation, and without it I had to take this step,” said Arends.

“If you asked her: ‘What would you think if I were to help you to die?’, she looked bewildered and said: ‘That’s going a bit far!’ I saw in her eyes that she didn’t understand it anymore.”

She added: “It was tremendously difficult, but for the best. I believed I was working within the boundaries of the law.”

Despite her requests, Arends judged her mentally incompetent and in “close consultation” with her family decided that she should be euthanised because of her prior directives – a decision that the Dutch courts eventually ruled was legal.

The doctor slipped a sedative into the woman’s coffee to relax her before administering the lethal injection. 

During the assisted suicide, the patient awoke and started to resist the procedure causing the doctor to ask the family for help in holding down the vulnerable woman while she finished the procedure.

In the court case that followed, prosecutors argued the doctor did not properly consult with the 74-year-old patient.

However, in 2019, a district court in The Hague ruled that doctors in the Netherlands can no longer be prosecuted for carrying out euthanasia on dementia patients who have previously given written consent.

Previously, those with dementia would need to reconfirm their earlier request.

in a summary of its decision, the Dutch Supreme Court stated: “A doctor can carry out an (earlier) written request for euthanasia from people with advanced dementia”.

The ruling, which was upheld earlier this year, not only exonerated Arends’ actions but means another legal safeguard protecting vulnerable people from euthanasia has been removed.

The case attracted critical attention when details were reported to the Regional Euthanasia Review Committees, which assesses all of the Netherlands’ roughly 6000 annual cases.

Over 200 Dutch doctors took out a newspaper advert saying they would not perform euthanasia for a patient with dementia without their confirmation.

However, Arends mantains she did the “right thing”, saying: “This was [a] unanimous [decision], a choice between an average residency of seven years, seven years of suffering, or – on the basis of the fundamental message in her living will – giving her the euthanasia she longed for.”

The country’s only euthanasia clinic recently revealed that it had seen a 22% increase in requests from people seeking assistance to end their lives last year compared to 2018.

There was also a 37% rise in requests from dementia patients, from 70 in 2018 to 96 in 2019.

(Image credit: The Dutch Broadcasting Foundation (Nederlandse Omroep Stichting – NOS))

Dutch court rules doctors can euthanise dementia patients who change mind

Doctors in the Netherlands can no longer be prosecuted for carrying out euthanasia on dementia patients who have previously given written consent.

Previously, those with dementia would need to reconfirm their earlier request.

But the Dutch Supreme Court ruled earlier this month this was no longer necessary.

“A doctor can carry out an (earlier) written request for euthanasia from people with advanced dementia,” the Supreme Court said in a summary of its decision.

The ruling means another legal safeguard has been removed.

The devastating move comes after a Dutch doctor was taken to court for carrying out an assisted suicide on a patient with Alzheimer’s.

The vulnerable patient had earlier written a directive asking for euthanasia in the event that she had been admitted to a nursing home due to dementia, but indicated she wanted to determine when “the time was right.” 

Once in the nursing home, she gave “mixed signals” about wanting to die.

And in the days leading up to the killing, the patient affirmed her desire to live, saying “I don’t want to die” on several occasions. 

Despite her requests, a doctor in “close consultation” with her family decided that she should receive an assisted suicide because of her prior statement.

The doctor slipped a sedative into the woman’s coffee to relax her before administering the lethal injection. 

During the assisted suicide, the patient awoke and started to to resist the procedure causing the doctor to ask the family for help in holding down the vulnerable woman down while they finished the procedure.

In the court case that followed, prosecutors argued the doctor did not properly consult with the 74-year-old patient.

“As long as the woman was able to communicate, the nursing home doctor should have kept talking to her about her desire to live or to die,” reads a statement from the prosecutor’s office.

“And as long as that conversation gave cause for doubt, the nursing home doctor should have refrained from euthanasia.”

However, the doctor has since been acquitted of any wrongdoing by a Dutch court that ruled “all requirements of the euthanasia legislation” had been met.

The law change announced earlier this month means cases such as these likely won’t even reach the courtroom.

In the Netherlands, euthanasia is legal if the person is deemed to be experiencing “hopeless and unbearable suffering” and chooses to end their life.

The country’s only euthanasia clinic recently revealed that it had seen a 22% increase in requests from people seeking assistance to end their lives last year compared to 2018.

There was also a 37% rise in requests from dementia patients, from 70 in 2018 to 96 in 2019.