Credit: Henk Monster, CC BY 3.0.
The number of cases of euthanasia and assisted suicide in the Netherlands has dropped for the first time since 2006. According to the government’s annual report on euthanasia, in 2018 it fell by 8.4%, from 6,685 cases in 2017 to 6126. This still represents 4% of all deaths in the country, but the proportion was higher the previous year, 4.4%.
It is unknown why the number has dipped. It could be just a statistical blip, as the figures already seem to be rising this year. The number of reported euthanasia cases increased by 9% in the first quarter of 2019 compared to the same period last year.
According to the regional review committee report for 2018, there were 5,898 cases of euthanasia (96.2%), 212 cases (3.4%) of assisted suicide, and in 16 cases (0.3%) a combination of the two. In all three categories, there was a slight decrease. The male-female ratio in the reports was virtually the same: 52.1% men to 47.9% women.
Cancer was most commonly cited as the main reason for requesting euthanasia, but there were 144 cases of people in the early stages of dementia, 67 of patients with psychiatric disorders and 205 of patients with a number of illnesses.
In six of the 6,126 reported instances of euthanasia, the government’s euthanasia commission decided that ruled that the doctor had not followed the mandatory protocols. Only one of them is being prosecuted.
In some highly significant developments, there were seven cases of organ donation after euthanasia and three cases of the euthanasia of children aged between 12 and 17. There were nine incidents of partners being euthanised together.
There was a lot of comment in the Dutch media about the decline. But not because it might be the first glimmer of a change of heart on the controversial procedure. On the contrary, it is because a steady increase is widely regarded as a sign of social progress.
The fact that a few doctors had been rapped over the knuckles for not following the established protocols and that one of them has actually been referred for prosecution – the first ever since legalisation in 2002! — may have spooked some Dutch doctors. The End of Life Clinic (Levenseindekliniek), a medical centre which specialises in providing euthanasia for patients whose own doctors are reluctant, claims that doctors are becoming more cautious in assessing patients out of fear of prosecution. “General practitioners who have already given euthanasia several times independently are now coming to us,” says clinic director Steven Pleiter.
You can see where this is leading. Supporters will protest that police interference has a chilling effect upon euthanasia. Therefore police should butt out and investigations into euthanasia deaths should be banned.
But the chairman of the Regional Review Committees on Euthanasia, Jacob Kohnstamm, believes that Dutch doctors are not that timid:
“I have a high opinion of medicine in the Netherlands. Imagine: a patient visits a doctor who is, in principle, willing to provide euthanasia. He has a patient who is suffering hopelessly and unbearably. And the doctor says: 'Oh dear, there is one doctor – out of a total of 18,000 euthanasia cases from 2016, 2017 and 2018 – who is being prosecuted. Now I am going to make this patient suffer unbearably '? My image of doctors is more positive than that. “
To be completely candid, I regard a decline in the number of euthanasia cases as good news. (That is, if it is true. It is possible that more cases were simply not reported to the authorities.) Fewer people euthanised means fewer people in desperate pain and fewer people who feel that their lives are meaningless.
However, this is obviously not the way that euthanasia supporters like the Levenseindekliniek and Mr Kohnstamm see it. For them a decline represents bad news because fewer people are taking advantage of the blessing of a peaceful death. From their point of view, the definition of good news is an ever-increasing, upward-sloping line on a graph of euthanasia deaths.
This raises an interesting question. Euthanasia already accounts for at least 4% of all deaths in the Netherlands. What proportion are its supporters aiming at? 5%? 10%? 40%? I have never read any projections of this figure. When will they relax and take their foot off the pedal? It would be interesting to know what the future holds for the Dutch.
Michael Cook is editor of MercatorNet.