Before euthanasia became legal in Holland I was for it now I am against. Too many people are being put down without consent, if elderly people are becoming scared to go to hospital because they don't want to be put down its gone very very wrong.
Involuntary Euthanasia is Out of Control in Holland
The Hague -- Euthanasia in The Netherlands is "beyond effective control", according to a report which shows that one in five assisted suicides is without explicit consent.
British opponents of assisted suicide say that the figures are a warning of the dangers of decriminalising euthanasia, as Holland did in 1984. By 1995 cases of euthanasia and assisted suicide in Holland had risen to almost 3 per cent of all deaths.
The Dutch survey, reviewed in the Journal of Medical Ethics, looked at the figures for 1995 and found that as well as 3,600 authorized cases there were 900 others in which doctors had acted without explicit consent. A follow-up survey found that the main reason for not consulting patients was that they had dementia or were otherwise not competent.
But in 15 percent of cases the doctors avoided any discussion because they thought they were acting in the patient's best interests.
Michael Howitt Wilson, of the Alert campaign against euthanasia, said: "A lot of people in Holland are frightened to go into hospital because of this situation."
Dr Henk Jochensen, of the Lindeboom Institute, and Dr John Keown, of Queens' College, Cambridge carried out the study. They conclude: "The reality is that a clear majority of cases of euthanasia, both with and without request, go unreported and unchecked. Dutch claims of effective regulation ring hollow."
Another study appearing in the journal shows that the legal assessments of cases reported to the public prosecution service in the Netherlands vary considerably. Cases are reported to determine whether a doctor will be prosecuted for murder. The study was carried out by Dr Jacqueline Cuperus-Bosma, of Vrije University in the Netherlands. The paper concluded that there is a need for clear protocols.
Dr Peggy Norris, chairwoman of the anti-euthanasia group Alert, said: "We need to learn from the Dutch system that euthanasia cannot be controlled."
"I know of patients in a nursing home who are carrying around what they call sanctuary certificates all the time, stating that they do not want to be helped to die. People are afraid of being sick or of being knocked down in case a doctor takes the decision, without their permission, to stop treatment."
Euthanasia law fuels
suffering in Holland
euthanasia-law-fuels-suffering-in-holland
Dr Els Borst was the architect of Holland's euthanasia law.
* Now the Dutch turn against legalised mercy killing (dailymail.co.uk, 09 December 2009)
* Supreme Court challenge to assisted suicide guidance (09 December 2009)
* Doctors voice concerns over DPP's assisted suicide policy (10 November 2009)
* Police boss fears assisted suicide danger for elderly (02 September 2009)
Thursday, 10 December 2009
Dr Els Borst, the architect of legal euthanasia in Holland, has admitted that she may have made a mistake in pushing the law through.
Dr Borst made the comments during an interview for a new book, Redeemer Under God.
The former Health Minister and Deputy Prime Minister admitted that care for the terminally-ill had declined since the law came into effect.
Dr Borst said: In the Netherlands, we first listened to the political and societal demand in favour of euthanasia.
She added: Obviously this was not in the proper order.
She also said that more should have been done to give legal protection to those who want to die naturally.
The author of Redeemer Under God, Dr Anne-Marie The, has studied euthanasia for 15 years. Her research found that the available palliative care in Holland was so inadequate that patients often ask for euthanasia out of fear.
She added: to think that we have neatly arranged everything by adopting the euthanasia law is an illusion.
Phyllis Bowman, of British campaign group Right to Life, says that because of the Dutch euthanasia law people can no longer get palliative care when they need it they just get an injection.
Ms Bowman said that Amsterdam, a city of 1.2 million people, only has two hospices.
Holland became the first country in the world to legalise voluntary euthanasia in 2002.
The number of cases of euthanasia in Holland has increased sharply in recent years.
In 2003 there were 1,626 cases while in 2008 there were 2,331 cases.
The Dutch Government has acknowledged that involuntary euthanasia poses a serious problem.
Euthanasia remains illegal in the UK.
However, earlier this year the Law Lords ordered the Director of Public Prosecutions, Kier Starmer, to issue draft guidance on when a person may be prosecuted for assisting suicide.
These guidelines are currently being challenged in the Supreme Court.
The word euthanasia comes from the Greek eu and thanatos, which together mean 'good death.' Euthanasia, sometimes called 'mercy killing,' is defined as the intentional killing of a patient either by act or omission, supposedly in the person's own interest. Voluntary euthanasia is killing the person at the person's request. Involuntary euthanasia is killing the person without his request, and possibly against his will. Nonvoluntary euthanasia is killing a person unable to make such a request, such as a young child or a sufferer from dementia.
There has been increased pressure for legalised euthanasia in recent years.
Whilst euthanasia was illegal in the Netherlands, the Dutch authorities agreed doctors would not be prosecuted for performing euthanasia provided guidelines were observed. These stated that euthanasia was to be for people who were terminally ill, in irrelievable pain, after repeated requests, with the consent of two doctors, and reported to the authorities.
A Dutch Government report in 1991, however, said that active euthanasia was performed on 1,000 patients in 1990 without an explicit request from the patient, and intentional lethal doses of morphine-like drugs were given to 4,941 patients without the patient's knowledge. A report in 1996 said in 1995 euthanasia was performed on 900 patients without an explicit request from the patient, intentional lethal overdoses were given to 1,889 without the patient's knowledge and medical treatment was withheld from 3,644 with the aim of hastening death. Many doctors had performed euthanasia without seeking a second doctor's opinion. In 1990 only 18 per cent of cases and in 1995 only 41 per cent of cases were reported to the authorities.
Dr Herbert Hendin, an American physician who authored a 1997 report following a visit by doctors to research euthanasia in Holland, said virtually every guideline had either failed to protect patients, been modified or been violated, and euthanasia, originally intended for the exceptional case, had become an accepted way of dealing with serious or terminal illness. The Dutch Parliament's lower house finally legalised euthanasia in Holland in 2000. Approval by Parliament's upper house was granted in April, 2001.
Cases unreported
A Dutch TV programme in 2003 claimed doctors were now performing euthanasia on thousands of patients without bothering to report it, as required by law, because they considered reporting it too time-consuming. The programme claimed that to avoid the legal procedure, doctors were giving lethal does of morphine under the pretext of pain management, or rendering patients unconscious with sedatives and allowing them to die of dehydration and starvation. Researchers in Holland who surveyed 5,600 doctors and interviewed 500 doctors in 2003 said almost half the cases in Holland went unreported because doctors wanted to avoid the hassle involved and were concerned that regulations might have been breached.
Since euthanasia was legalised in Holland, euthanasia has been performed there on people who were not terminally ill, and on children. It is now to be extended to include euthanasia of infants.
Euthanasia in the Netherlands
Note: This fact sheet is based upon developments in the Netherlands through 1994. It includes data from the "Remmelink Report." For information on developments in Dutch euthanasia and assisted suicide, see the IAETF Update general index or the Update Search.
Right-to-die advocates often point to Holland as the model for how well physician-assisted, voluntary euthanasia for terminally-ill, competent patients can work without abuse. But the facts indicate otherwise.
BACKGROUND INFORMATION
Dutch Penal Code Articles 293 and 294 make both euthanasia and assisted suicide illegal, even today. However, as the result of various court cases, doctors who directly kill patients or help patients kill themselves will not be prosecuted as long as they follow certain guidelines. In addition to the current requirements that physicians report every euthanasia/assisted-suicide death to the local prosecutor and that the patient's death request must be enduring (carefully considered and requested on more than one occasion), the Rotterdam court in 1981 established the following guidelines:
1. The patient must be experiencing unbearable pain.
2. The patient must be conscious.
3. The death request must be voluntary.
4. The patient must have been given alternatives to euthanasia and time to consider these alternatives.
5. There must be no other reasonable solutions to the problem.
6. The patient's death cannot inflict unnecessary suffering on others.
7. There must be more than one person involved in the euthanasia decision.
8. Only a doctor can euthanize a patient.
9. Great care must be taken in actually making the death decision. (1)
Since 1981, these guidelines have been interpreted by the Dutch courts and Royal Dutch Medical Association (KNMG) in ever-broadening terms. One example is the interpretation of the "unbearable pain" requirement reflected in the Hague Court of Appeal's 1986 decision. The court ruled that the pain guideline was not limited to physical pain, and that "psychic suffering" or "the potential disfigurement of personality" could also be grounds for euthanasia. (2)
The main argument in favor of euthanasia in Holland has always been the need for more patient autonomy -- that patients have the right to make their own end-of-life decisions. Yet, over the past 20 years, Dutch euthanasia practice has ultimately given doctors, not patients, more and more power. The question of whether a patient should live or die is often decided exclusively by a doctor or a team of physicians.(3)
The Dutch define "euthanasia" in a very limited way: "Euthanasia is understood [as] an action which aims at taking the life of another at the latter's expressed request. It concerns an action of which death is the purpose and the result." (4) (Emphasis added.) This definition applies only to voluntary euthanasia and excludes what the rest of the world refers to as non-voluntary or involuntary euthanasia, the killing of a patient without the patient's knowledge or consent. The Dutch call this "life-terminating treatment."
Some physicians use this distinction between "euthanasia" and "life-terminating treatment" to avoid having a patient's death classified as "euthanasia," thus freeing doctors from following the established euthanasia guidelines and reporting the death to local authorities. One such example was discussed during the December 1990 Institute for Bioethics conference in Maastricht, Holland. A physician from The Netherlands Cancer Institute told of approximately 30 cases a year where doctors ended patients' lives after the patients intentionally had been put into a coma by means of a morphine injection. The Cancer Institute physician then stated that these deaths were not considered "euthanasia" because they were not voluntary, and that to have discussed the plan to end these patients' lives with the patients would have been "rude" since they all knew they had incurable conditions. (5)
For the sake of clarity in this fact sheet, the direct and intentional termination of a patient's life, performed without the patient's consent, will be termed "involuntary euthanasia."
THE FACTS
The Remmelink Report-- On September 10, 1991, the results of the first, official government study of the practice of Dutch euthanasia were released. The two volume report (6)--popularly referred to as the Remmelink Report (after Professor J. Remmelink, M.J., attorney general of the High Council of the Netherlands, who headed the study committee)--documents the prevalence of involuntary euthanasia in Holland, as well as the fact that, to a large degree, doctors have taken over end-of-life decision making regarding euthanasia. The data indicate that, despite long-standing, court-approved euthanasia guidelines developed to protect patients, abuse has become an accepted norm. According to the Remmelink Report, in 1990:
* 2,300 people died as the result of doctors killing them upon request (active, voluntary euthanasia).(7)
* 400 people died as a result of doctors providing them with the means to kill themselves (physician-assisted suicide).(8)
* 1,040 people (an average of 3 per day) died from involuntary euthanasia, meaning that doctors actively killed these patients without the patients' knowledge or consent.(9)
o 14% of these patients were fully competent. (10)
o 72% had never given any indication that they would want their lives terminated. (11)
o In 8% of the cases, doctors performed involuntary euthanasia despite the fact that they believed alternative options were still possible. (12)
* In addition, 8,100 patients died as a result of doctors deliberately giving them overdoses of pain medication, not for the primary purpose of controlling pain, but to hasten the patient's death. (13) In 61% of these cases (4,941 patients), the intentional overdose was given without the patient's consent.(14)
* According to the Remmelink Report, Dutch physicians deliberately and intentionally ended the lives of 11,840 people by lethal overdoses or injections--a figure which accounts for 9.1% of the annual overall death rate of 130,000 per year. The majority of all euthanasia deaths in Holland are involuntary deaths.
* The Remmelink Report figures cited here do not include thousands of other cases, also reported in the study, in which life-sustaining treatment was withheld or withdrawn without the patient's consent and with the intention of causing the patient's death. (15) Nor do the figures include cases of involuntary euthanasia performed on disabled newborns, children with life-threatening conditions, or psychiatric patients. (16)
* The most frequently cited reasons given for ending the lives of patients without their knowledge or consent were: "low quality of life," "no prospect for improvement," and "the family couldn't take it anymore."(17)
* In 45% of cases involving hospitalized patients who were involuntarily euthanized, the patients' families had no knowledge that their loved ones' lives were deliberately terminated by doctors. (18)
* According to the 1990 census, the population of Holland is approximately 15 million. That is only half the population of California. To get some idea of how the Remmelink Report statistics would apply to the U.S., those figures would have to be multiplied 16.6 times (based on the 1990 U.S. census population of approximately 250 million).
Falsified Death Certificates ---In the overwhelming majority of Dutch euthanasia cases, doctors--in order to avoid additional paperwork and scrutiny from local authorities--deliberately falsify patients' death certificates, stating that the deaths occurred from natural causes. (19) In reference to Dutch euthanasia guidelines and the requirement that physicians report all euthanasia and assisted-suicide deaths to local prosecutors, a government health inspector recently told the New York Times: "In the end the system depends on the integrity of the physician, of what and how he reports. If the family doctor does not report a case of voluntary euthanasia or an assisted suicide, there is nothing to control." (20)
Inadequate Pain Control and Comfort Care -- In 1988, the British Medical Association released the findings of a study on Dutch euthanasia conducted at the request of British right-to-die advocates. The study found that, in spite of the fact that medical care is provided to everyone in Holland, palliative care (comfort care) programs, with adequate pain control techniques and knowledge, were poorly developed. (21) Where euthanasia is an accepted medical solution to patients' pain and suffering, there is little incentive to develop programs which provide modern, available, and effective pain control for patients. As of mid-1990, only two hospice programs were in operation in all of Holland, and the services they provided were very limited. (22)
Broadening Interpretations of Euthanasia Guidelines
* In July 1992, the Dutch Pediatric Association announced that it was issuing formal guidelines for killing severely handicapped newborns. Dr. Zier Versluys, chairman of the association's Working Group on Neonatal Ethics, said that "Both for the parents and the children, an early death is better than life." Dr. Versluys also indicated that euthanasia is an integral part of good medical practice in relation to newborn babies. (23) Doctors would judge if a baby's "quality of life" is such that the baby should be killed.
* A 2/15/93 statement released by the Dutch Justice Ministry proposed extending the court-approved, euthanasia guidelines to formally include "active medical intervention to cut short life without an express request." (Emphasis added.) Liesbeth Rensman, a spokesperson for the Ministry, said that this would be the first step toward the official sanctioning of euthanasia for those who cannot ask for it, particularly psychiatric patients and handicapped newborns.(24)
* A 4/21/93 landmark Dutch court decision affirmed euthanasia for psychiatric reasons. The court found that psychiatrist Dr. Boudewijn Chabot was medically justified and followed established euthanasia guidelines in helping his physically healthy, but depressed, patient commit suicide. The patient, 50-year-old Hilly Bosscher, said she wanted to die after the deaths of her two children and the subsequent breakup of her marriage.(25)
Euthanasia "Fallout" -- The effects of euthanasia policy and practice have been felt in all segments of Dutch society:
* Some Dutch doctors provide "self-help programs" for adolescents to end their lives. (26)
* General practitioners wishing to admit elderly patients to hospitals have sometimes been advised to give the patients lethal injections instead. (27)
* Cost containment is one of the main aims of Dutch health care policy. (28)
* Euthanasia training has been part of both medical and nursing school curricula. (29)
* Euthanasia has been administered to people with diabetes, rheumatism, multiple sclerosis, AIDS, bronchitis, and accident victims. (30)
* In 1990, the Dutch Patients' Association, a disability rights organization, developed wallet-size cards which state that if the signer is admitted to a hospital "no treatment be administered with the intention to terminate life." Many in Holland see the card as a necessity to help prevent involuntary euthanasia being performed on those who do not want their lives ended, especially those whose lives are considered low in quality. (31)
* In 1993, the Dutch senior citizens' group, the Protestant Christian Elderly Society, surveyed 2,066 seniors on general health care issues. The Survey did not address the euthanasia issue in any way, yet ten percent of the elderly respondents clearly indicated that, because of the Dutch euthanasia policy, they are afraid that their lives could be terminated without their request. According to the Elderly Society director, Hans Homans. "They are afraid that at a certain moment, on the basis of age, a treatment will be considered no longer economically viable, and an early end to their lives will be made." (32)
The Irony of History -- During World War ll, Holland was the only occupied country whose doctors refused to participate in the German euthanasia program. Dutch physicians openly defied an order to treat only those patients who had a good chance of full recovery. They recognized that to comply with the order would have been the first step away from their duty to care for all patients. The German officer who gave that order was later executed for war crimes. Remarkably, during the entire German occupation of Holland, Dutch doctors never recommended nor participated in one euthanasia death. (33) Commenting on this fact in his essay "The Humane Holocaust," highly respected British journalist Malcolm Muggeridge wrote that it took only a few decades "to transform a war crime into an act of compassion." (34)
Implications of the Dutch Euthanasia Experience
* Right-to-die advocates often argue that euthanasia and assisted suicide are "choice issues." The Dutch experience clearly indicates that, where voluntary euthanasia and assisted suicide are accepted practice, a significant number of patients end up having no choice at all.
* Euthanasia does not remain a "right" only for the terminally-ill, competent adult who requests it, no matter how many safeguards are established. As a "right," it inevitably is applied to those who are chronically ill, disabled, elderly, mentally ill, mentally retarded, and depressed-- the rationale being that such individuals should have the same "right" to end their suffering as anyone else, even if they do not or cannot voluntarily request death.
* Euthanasia, by its very nature, is an abuse and the ultimate abandonment of patients.
* In actual practice, euthanasia only gives doctors greater power and a license to kill.
* Once the power to kill is bestowed on physicians, the inherent nature of the doctor/patient relationship is adversely affected. A patient can no longer be sure what role the doctor will play--healer or killer.
* Unlike Holland, where medical care is automatically provided for everyone, in the U.S. millions of people cannot afford medical treatment. If euthanasia and assisted-suicide were to become accepted in the U.S., death would be the only "medical option" many could afford.
* Even with health care reform in the U.S., many people would still not have long-standing relationships with their doctors. Large numbers of Americans would belong to health maintenance organizations (HMOs) and managed care programs, and they often would not even know the physicians who end up treating them. Given those circumstances, doctors would be ill-equipped to recognize if a patient's euthanasia request was the result of depression or the sometimes subtle pressures placed on the patient to "get out of the way." Also, given the current push for health care cost containment in the U.S., medical groups and facilities many be tempted to view patients in terms of their treatment costs instead of their innate value as human beings. For some, the "bottom line" would be, "Dead patients cost less than live ones."
* Giving doctors the legal power to kill their patients is dangerous public policy.
If you think you have the right to put someone in a medically induced coma and starve them to dealth because YOU think their life is not worth living there is something wrong. For these parents of disabled children would you have wanted some doctor deciding your child should die? I remember one story about a family who had doctors telling them that their baby boy was going to be so mentally retarded it wasn't worth treating, they spent three years fighting to get him treatment and at three it was found there was nothing wrong with him yet because of a faulty diagnosis they where going to kill him. It is also believed to be ok to kill babies with spina bifida. This attitude that the doctor knows best is what fuels people like Harold Shipman who killed over 200 of his elderly patients the nastiest thing of his story though was his wife tried to claim back jewellery he had stollen from his victims as he committed suicide before being found guilty of murder.
i feel this way about most everything. It's that old maxim, so long as it doesn't hurt anyone else...
As a nursing home worker, who has seen both the great & awful sides of the end of life, I've made my daughters give me a promise. It was that when I get bad enough, they will get me a tan coat and a white hat & gloves, then turn me loose in the woods during deer season!!! although since I've gained weight again, maybe I should go for all dark brown during MOOSE SEASON? 
