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Journal writers: Dutch tumbling down death’s ‘slippery slope’

NASHVILLE, Tenn. (BP)–Despite claims to the contrary by the Royal Dutch Medical Association, the legalization of assisted suicide in the Netherlands has moved the country quickly down the “slippery slope” toward a no-holds-barred “culture of death,” according to the authors of a commentary in the June 4 Journal of the American Medical Association.
Noting it was two decades ago the Dutch government legalized physician-assisted suicide and euthanasia, the authors said the nation “has moved from considering assisted suicide to giving legal sanction to both physician-assisted suicide and euthanasia, from euthanasia for terminally ill patients to euthanasia for those who are chronically ill, from euthanasia for physical illness to euthanasia for psychological distress, and from voluntary euthanasia to nonvoluntary and involuntary euthanasia.” The commentary was authored by Herbert Hendin of the New York Medical College’s department of psychiatry in New York City; Chris Rutenfrans of the Department of Justice at The Hague; and Zbigniew Zylicz of Hospice Rosenhuyvel in Rosendaal, the Netherlands.
The article alleged “an erosion of medical standards in the care of terminally ill patients” in the Netherlands, based upon 1990 and 1995 studies by the country’s medical association in which doctors were promised immunity from prosecution for the information they gave investigators.
The article’s authors suggested the government’s inability to contain the life-ending processes within established rules was more slippery than the fact that euthanasia was being extended to more patients than legally sanctioned. The authors noted nearly every guideline installed by the Dutch — “a voluntary, well-considered, persistent request; intolerable suffering that cannot be relieved; consultation; and reporting of cases” — had failed to protect patients and was being subverted in some way or another.
Given that Dutch efforts at regulating assisted suicide and euthanasia have served as a model for some U.S. statutes on the practices, the authors warn the regulations are often ignored by the medical community.
“Hendin, Rutenfrans and Zylicz are right on target,” agreed C. Ben Mitchell, professor of Christian ethics at Southern Baptist Theological Seminary, Louisville, Ky. “Any honest examination of the data will confirm that Dutch physicians have slid down the slope into the moral abyss.”
The JAMA article said other studies conducted in the Netherlands have indicated how voluntariness is compromised, that alternatives are not presented, and the criterion of unrelievable suffering is bypassed by physicians.
A Dutch physician who was filmed ending the life of a patient recently diagnosed with amyotrophic lateral sclerosis said of the patient, “I can give him the finest wheelchair there is, but in the end it is only a stopgap. He’s going to die and he knows it,” Hendin, Rutenfrans and Zylicz reported.
The authors recounted the story of a patient with disseminated breast cancer who had made it clear she did not want euthanasia. Despite her stated wishes, a Dutch physician ended her life because, “It could have taken another week before she dies, I just needed this bed.”
According to the article’s authors, the most alarming concern arising from the Dutch studies was the documentation of cases in which patients who have not given their consent had nonetheless had their lives ended by physicians.
Nearly 25 percent of the physicians stated they had “terminated the lives of patients without an explicit request” from the patient.
Mitchell said the medical paternalism demonstrated by many Dutch physicians in the study is “simply frightening.”
“When we give physicians god-like power, we should expect them to use it to destroy those they don’t think should be alive,” said Mitchell, who also serves as a consultant on life issues with the Southern Baptist Ethics and Religious Liberty Commission. “This is nothing less than institutionalized murder.”
The study revealed 59 percent of the country’s physicians do not report their involvement in assisted suicide and euthanasia, and more than 50 percent of the doctors surveyed “feel free to suggest euthanasia to their patients.”
Euthanasia, intended originally for the exceptional case, has become an accepted way of dealing with serious or terminal illness in the Netherlands, the authors contended. Palliative care, the efforts of medical professionals to relieve a patient’s suffering, is a casualty in the rush to employ life-ending techniques, the authors continued.
Their study also discovered an increase in the number of deaths in which physicians gave pain medication with the explicit intention of ending the patient’s life. In 80 percent of these cases the patient made no request for death, a finding the authors called “striking.”
There was an increase of 27 percent from the 1990 study in cases in which physicians actively intervened to cause death — counting the deaths that resulted from euthanasia, assisted suicide, ending the life of a patient without consent, and giving opioid with the explicit intention of ending life — the authors said, calling on the U.S. medical profession to “avoid making the Dutch mistake.”

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  • Dwayne Hastings