During euthanasia, a physician administers lethal medication to a patient at the patient's request, in order to end hopeless and unbearable suffering.1 In 2002, the Netherlands was the first country in the world to adopt legislation that allows euthanasia under certain strict conditions.2 Euthanasia is still illegal as described in the Dutch Criminal Code, articles 293 and 294. However, physicians are exempted from criminal liability when they report their actions to the local coroner and comply with the due care criteria from The Dutch Termination of Life on Request and Assisted Suicide Act (WTL).3
The due care criteria include that the physician:
According to the WTL, the physician has to report the euthanasia to the local coroner and has to present a written report with points of concern. These points of concern are derived from the due care criteria of article 2 of the WTL. The local coroner then sends the report tot the Public Prosecutor and to one of the five regional review committees. A regional review committee consists of a lawyer, a physician and an ethicist. The committee reviews the case critically and draws up a written judgement within six weeks. If the physician did not comply with the due care criteria, this will be reported to the public prosecutor's office and the Inspection for Medical Care. Both authorities will determine whether further action is necessary.
1. H.J.J. Leenen e.a., Handboek Gezondheidsrecht, Den Haag: Boom Juridische Uitgevers 2014, p. 391-395.
2. H.A.M. Weyers, EUTHANASIE. Het proces van rechtsverandering, Amsterdam University Press 2004, p. 3-10.
3. H.J.J. Leenen e.a., Handboek Gezondheidsrecht, Den Haag: Boom Juridische Uitgevers 2014, p. 396.
Euthansia is the practice of a physican to terminate a patient's life at his explicit request to end unbearable and hopeless suffering. Euthanasia must be seen as an ultimate remedy. It can only be administered in those situation in which suffering cannot be alleviated in any other acceptable manner.
When assisting in suicide, the physician provides lethal medication for the purpose by a patient to end unbearable and hopeless suffering. As with euthanasia, assisted suicide must be seen as the last option. It may only be practiced if the patient's suffering cannot be alleviated in any other manner.
In terminal sedation, the consciousness of the patient in the final phase of his life is deliberately reduced with the intent of alleviating suffering. Terminal sedation cannot be seen as a form of termination of life, because it is not practiced with the purpose to let the patient die sooner.