The Dying Dutchman: Coming Soon to a Nursing Home Near You
Fumento, Michael
Michael Fumento THE DYING DUTCHMAN: COMING SOON TO A NURSING HOME NEAR YOU For eighteen years, euthanasia has been widespread in the Netherlands. Many Dutch claim that the practice is often...
...Still, it is worth remembering that the engine which drove the early moral transformation of German medicine was not the ideology of racial discrimination, but medical economics...
...In every case but one, punishment imposed by a lower court has been reversed on a technicality by a higher court...
...Cancer, he says, accounts for about 80 percent of euthanasias, and about 10 percent of cancer patients are euthanized...
...We are the first country in the world moving this way...
...tee in Washington expressed fears that the debate would soon be over: "What is left to argue here is whether it will be possible in this society to preserve the lives of those who don't want to be killed...
...A doctor was cited by the Dutch Medical Disciplinary Board for "breach of trust" in misleading a patient into supposing that he was being given a lethal dose of drugs when the doctor knew otherwise...
...How Voluntary Is "Voluntary...
...Admiraal says, "There's no possibility of euthanasia for demented patients because they cannot voluntarily ask for it...
...Fenigsen writes: For 20 years, the population of Holland has been subjected to all-intrusive propaganda in favor of death...
...Courts have added a third condition since 1984: that a physician must consult a colleague in order to confirm the correctness of his diagnosis and prognosis, to verify the correct medical performance of euthanasia, and to assure that all legal requirements are met...
...Gunning, however, says, "Quite a number of doctors really don't like it after all...
...unlawfully killing his patient...
...most requests come from the family...
...Bakker put it, "the patient must ask the doctor [to be euthanized...
...His protocol involves the consultation of two doctors, a nurse, and a pastor...
...Down's syndrome and spina bifida cases represent similar situations...
...Dutch polling data seem to indicate a high level of support for euthanasia, though the numbers vary widely...
...A higher court overruled the verdict on technical grounds (the collection of evidence against the doctor was considered irregular), after which a civil court granted him $150,000 in damages against the Netherlands for having spent several months in jail...
...Reluctantly, the healthy soldier does so...
...In the present discussion about euthanasia, too little attention is being given to the improvement of care as an alternative to life termination...
...One with whom I spoke was a fiercely traditional, pm-family, anti-Communist general practitioner...
...It must not be allowed merely because the family thinks it is best or the doctor thinks the world is better off...
...I don't believe we can prevent it...
...Certainly her attitude is reflected in her concern over what a new euthanasia statute would look like...
...For one who is responsible for prosecuting crimes to work to decriminalize them would in the United States constitute a clear conflict of interest, but such is the mood in the Netherlands that he has encountered little criticism...
...He was eventually convicted of killing three patients and received an unconditional one-year prison sentence, though the prosecutor requested eight years...
...Can It Happen Here...
...I'm sure some people do it for purely humanitarian reasons," he says, "but others I'm sure do it for purely demographic reasons...
...This includes only those killed by their own family doctor, not those killed in hospitals...
...The KNMG, together with the Dutch nurses' union, issued a joint paper in March 1987 that not only explicitly advocates euthanasia but also clearly delineates the respective tasks and the collaboration of both medical and nursing professions at the bedside of the future victim...
...This may once have been the typical situation, but critics charge that in more and more instances, Netherlands euthanasia is neither voluntary nor restricted to cases of impending death...
...Another commentator writes that it means that "euthanasia should not become an answer to failing care, fear, and loneliness...
...We will find it extremely dangerous and frightening if the new medical legislation includes euthanasia...
...An American scholar has written, "A right to die, once accepted, too easily becomes a duty to die, or an excuse to kill...
...Unlike Bakker, he is not pushing for statutory legalization...
...So I'm a little bit afraid...
...First, thepatient must make the request freely...
...This prompted one commentator in the Times of London to suggest that the doctor was in effect found guilty of "not...
...If prosecution occurs, the Lower Court, comprising three judges, tries the case and, upon conviction, pronounces sentence...
...THE AMERICAN SPECTATOR OCTOBER 1991 19 to die" How about a comatose patient...
...In the spring of 1985, a doctor came under suspicion of killing at least twenty patients at a nursing home in the Hague...
...Dr...
...He with power to kill had power to cure, including specially the undoing of his own killing activities...
...A group of people with severe disabilities stated in their letter to the Parliamentary Committees for Health Care and Justice: We feel our lives threatened...
...In America, the pressures which exist or can be reasonably anticipated seem much less, and the abuses of medical killing which can be reasonably anticipated seem likely to be correspondingly milder...
...One gets the idea that Mrs...
...A third pro-euthanist, one with a slightly different angle on the subject, is Eugene Sutorius...
...But van der Sluis says that, among other nations, the US...
...The latest round of controversy began last March when Rochester, New York, doctor Timothy E. Quill admitted in the New England Journal of Medicine that he had prescribed sleeping pills to an ill patient who he knew would use them to kill herself...
...Of these, 37 percent said they had complied...
...Down the Slippery Slope If the original purpose of euthanasia was to provide terminal patients with a chance of checking out early, then abuses have already been institutionalized in the form of euthanizing non-terminal patients, newborns, and those in comas...
...Under Admiraal's protocol, the "family has no rights at all...
...Theo van Berkestijn, then-director of the association, said the organization had concluded that "the most important thing is that [the physician] keep the trust of the child...
...A Missouri judge ruled that a comatose woman's parents could have her feeding tube removed...
...It must be a possibility for those who want to die, and for no other reason...
...He who had power to cure would necessarily also be able to kill...
...All efforts are made to convince people that that is what they ought to do, what society expects of them, what is best for themselves and their families...
...Says Gunning, "The only way we [publish] is [in] advertisements or our own publication...
...Such hearsay hardly constitutes a patient request for euthanasia, but the doctor killed the man nonetheless and claimed to have been quite proud of it, says van der Sluis...
...it refers to a family doctor's practice in his own home, which is still common in the Netherlands...
...He eventually confessed to five, explaining that his actions had been justified because the patients had, as much as four years earlier, made such remarks as, "I do not want to- become a vegetable...
...She thinks statutory legalization "will give security to doctors and patients because they'll know their rights and it will take away those behind-the-curtain cases...
...I think euthanasia shows we can't cope with technology," he says...
...These two developments pushed euthanasia into the limelight of public policy debate In all court cases between 1973 and 1984, two conditions were listed as essential to euthanasia's legality...
...So tough, in fact, he would not give me an answer...
...If they're in a coma, there's no consciousness, so it's not cruel...
...But polls confirm that many people in the Netherlands believe involuntary euthanasia is common...
...The other is utilitarian, and says that the needs of society should be considered in the decision...
...But here, as in the U.S., people are idealists...
...One poll of the elderly found that those living independently favored euthanasia at dramatically higher rates than residents of nursing homes...
...I don't think there's a lot to gain [monetarily or in other concrete ways] by supporting euthanasia, so those who say they believe in it really do...
...The court went even further to find that, under the proper conditions, active euthanasia would have been acceptable and legal...
...The significance of the doctor's Hippocratic Oath, Margaret Mead noted, was that for the first time in our tradition there was a complete separation between killing and curing...
...No official statistics on the overall incidence of euthanasia in the Netherlands exist...
...The Combatants The Netherlands is not without opposition to euthanasia...
...They advised the families to inquire about every step in their relative's treatment and, when in doubt, to consult a reliable expert outside the hospital...
...He says Dutch television offers "constant performances of someone suffering" and who is therefore a good candidate for euthanasia, but at the same time there is much talk in the country about the "tremendous cost to society" of an aging population...
...Hospices are institutions designed to allow dying people to live out their lives as comfortably as possible...
...1 on the New York limes bestseller list...
...During six years of follow-up, the patient never made the request again...
...is Dr...
...Today, it is the German physicians who have taken the lead in actively rejecting euthanasia...
...A "request" for euthanasia can be defined quite loosely, to say the least...
...Interestingly, even though both Bakker and Admiraal will state forcefully that they always oppose involuntary euthanasia, they say they support euthanizing severely defective newborns...
...Assisting in a suicide is a felony in Quill's jurisdiction, and the publication of the article was clearly intended to stir debate...
...Yet euthanasia opponents say that, outside of Admiraal's de Graaf hospital, involuntary euthanasia does occur at familial request...
...Admiraal recommends for euthanasia...
...After the act, the prosecutor is informed...
...One survey in the northern Netherlands, if extrapolated, would indicate 5,000 euthanasia deaths annually...
...Yes, of course it is impossible—if that's how strictly you define euthanasia...
...lb this, he related the story of a friend's father who had asked to be killed if he reached a certain level of debilitation...
...could be the closest to following the Netherlands model...
...The following year, the Royal Dutch Medical Association (KNMG) issued a provisional statement urging that legally euthanasia should remain a crime, but that if a physician, after having considered all the aspects of the case, shortens the life of a patient who is incurably ill and in the process of dying, the court will have to judge whether there was a conflict of duties which could justify the act of the physician...
...Isaac van der Sluis also fears giving too much power to doctors...
...She says her organization opposes abuses, but this appears to be with nothing more than an occasional verbal disclaimer...
...The establishment" seems clearly on the side of expanded euthanasia...
...The KNMG guidelines appear conservative when compared to legislative proposals or judicial decisions, but they still do not require a terminal illness, an impending death, or a written request—safeguards that would increase the possibility of objective verification...
...Then the question is, Will people believe you or the official papers?'" The mainstream media, he says, are overwhelmingly pro-euthanasia...
...According to van der Sluis, one terminally ill woman reported that, after an especially painful night, her doctor asked her, "Shall I give you an injection now...
...Admiraal specifically rejects the hospice system that began in the United Kingdom and has subsequently been adopted in the United States...
...Richard Fenigsen, a cardiologist...
...Throughout the primitive world the doctor and the sorcerer tended to be the same person...
...Amsterdam dermatologist Dr...
...This is something to think about as medical costs in the US...
...T he anti-euthanists are clearly the 1 underdogs...
...That we are in the midst of the greatest push yet for euthanasia is clear not only from the uproar over Final Exit but also from a series of other widely publicized incidents...
...Of 500 patients who died, only six or seven requested a fatal injection, and in most of these cases, they dropped the request after a conversation...
...These opponents are a disparate lot...
...Admiraal says, "Even if your wife wanted to stop it she couldn't...
...In a case of life and death we must be very careful," says party spokesman Jan Schinkelshoek...
...The answer may lie in the experience of the Netherlands, where it has been widely practiced for nearly two decades now...
...Formerly, the police were routinely contacted but that is no longer the case...
...The representativeness of his experience may be questioned since, as a cardiologist and not a general practitioner, he might not be in a position to get many requests...
...An average of only eleven euthanasia cases a year prompt public prosecutors even to make inquiries...
...Admiraal was tried for ending the life of a young girl with multiple sclerosis who, though suffering, could have been expected to live indefinitely...
...One profession, the followers of Asclepius, were able to be dedicated completely to life under all circumstances, regardless of rank, age, or intellect—the life of a slave, the life of the Emperor, the life of a foreign man, the life of a defective child...
...Some Dutch carry a will requiring active euthanasia to be performed on them "in case of bodily injury or mental disturbance of which no recovery to reasonable and dignified existence is to be expected...
...In the words of Eugene P. R. Sutorius, attorney for the Dutch Society for Voluntary Euthanasia, "Euthanasia is only acceptable if it is the keystone of a well-cared-for dying process...
...In 1985, Dr...
...Prominent among the opposition physicians is Dr...
...But the Dutch all knew what I was talking about, though they hadn't necessarily given it much thought...
...Even pro-euthanists occasionally concede they're headed down the slippery slope...
...It is difficult to gauge how many Dutch doctors perform euthanasia...
...With the Greeks, the distinction was made clear...
...The physician decided simply to allow the child to starve to death, believing that starvation would cause death in two days...
...Said Admiraal, "I think it's quite normal for society to ask for euthanasia of newborns and for allowing the death of [people in] comas...
...Admiraal told me, "There's no room for involuntary euthanasia," I asked him about euthanizing newborns and he stated flatly, "That's involuntary euthanasia...
...Is Euthanasia "Necessary...
...In Sweden, Belgium, and England there are already signs of complacency towards the idea of killing certain patients...
...I think comas won't be accepted by nursing homes today, because there's not enough room as it is," he says...
...The Netherlands' leading specialist in pediatric oncology, Professor P. A. Voute, revealed that since the early 1980s it had been his practice, at times on his own initiative, to provide some of his patients with doses of poison, enabling them to commit suicide if they wished...
...But, according to Dr...
...Estimates are that, by 2025, the number of people 100 or older will increase from 25,000 to 400,000...
...Clearly the definition of "voluntary" is affected by the amount of initiative a doctor takes...
...Van der Sluis describes one general practitioner explaining how he was persuaded by the patient's wife: You know, doctor, my husband is looking all the time at my father's picture on the wall, and he thinks my father would not have approved his leaving me alone...
...In explaining why he wrote a how-to booklet on euthanasia, which appeared in 1977, he told me, "It's not so simple to kill somebody the honest way...
...Bakker's reaction to questions of abuse seems particularly disconcerting...
...How Strong Is Popular Support...
...He would have said that you certainly earned your rest...
...Certainly he does not fit the description of a man who has been killing patients for almost two decades now...
...A recent movie here tells the true story of a Dutch soldier trapped behind enemy lines in the Korean War...
...In that case, we can stop the life of the baby...
...But I told him: What nonsense...
...Says Bakker of the anti-euthanists, "They are always saying, 'I'm afraid, I'm afraid.' But you can't live in fear...
...Admiraal said, "It's not so simple to kill somebody the honest way...
...He would then kill the now-comatose patient with a large dose of insulin...
...Gunning calls "utilitarian" euthanasia is another word for "involuntary...
...Then you must have made your decision...
...Many people think we are useless...
...And maybe we don't know what we are doing...
...If convicted, the defendant can appeal first to the Court of Appeals and then to the Supreme Court...
...He said it gave him "a liberating certainty and a feeling of elation that I had done such a radical thing all on my own...
...I can imagine that...
...The euthanasia proponents I talked to all insisted that, as Mrs...
...20 THE AMERICAN SPECTATOR OCTOBER 1991 calls "crypthanasia" is not shunned as an "abuse" but widely accepted, openly supported, and praised as a charitable deed...
...Karel F. Gunning, a general practitioner in Rotterdam who advises the government on the medical problems of German concentration camp survivors...
...The only case in which a conviction has been upheld was the 1973 case that started the euthanasia boom...
...Quill, a spokesman for the National Right to Life CommitMichael Fumento is author of The Myth of Heterosexual AIDS (New Republic Books...
...As Dr...
...Some Protestant and Catholic newspapers are against it, but all the leading papers are on the wrong side...
...Dutch euthanasia opponents aver that one need not adopt a "pro-life" philosophical outlook to fmd that voluntary euthanasia is still a needless practice, that an understanding doctor and improved conditions can almost always prevent requests for death...
...More specifically, they said the instances Fenigsen cited as being euthanasia abuses were not euthanasia because euthanasia is by definition "a deliberate life-ending action by another person than the concerned person at the enduring request of the latter," to quote from one letter signed by twenty-five prominent pro-euthanists...
...While nursing personnel are clearly excluded from performing the actual killing, total collaboration is nonetheless called for, and it is considered normal conduct for nursing personnel to be involved in medical decisions...
...Obviously, what Dr...
...What would happen in a United States with legalized euthanasia...
...And the subject leads the question of child euthanasia...
...We have justices and police to do that...
...They want to be able to trust the government and doctors to do the right thing...
...A Colorado man gave his mother a gun which she used to end her life before liver cancer could—only to find out at the autopsy that his mother had been misdiagnosed and merely had a liver inflammation...
...The KNMG thinks teen-agers and even younger children should have the right THE AMERICAN SPECTATOR OCTOBER 1991 21 to choose to be killed, even without parental consent, and has advocated the elimination of age limits from any euthanasia legalization bill...
...It's very, very clean...
...He sees modern medicine and its ever-growing ability to sustain life as something of a culprit in making euthanasia necessary...
...A young woman whose own father had been killed by euthanasia saw it as an answer only if death was imminent and the person was in great pain, circumstances she said applied to her father...
...But, Gunning adds, "it is enormously dangerous to think that doctors, who aren't the most conscientious people in the world, should have the right to kill—and kill unchallenged...
...in fact, it can't even stop a request for euthanasia...
...Amsterdam n August 8, it was announced that V Final Exit, by Derek Humphry, had risen to No...
...Admiraal began administering euthanasia in the early 1970s and only later became involved with pro-euthanasia organizations...
...Sometimes a 15-year-old child can have a mature judgment...
...Most of these babies have severe neurological problems and if there's no possibility [of correcting them, doctors] will decide with the parents what to do...
...Of the Netherlands' anti-euthanists, the best known in the U.S...
...Many Dutch claim that the practice is often involuntary, that the consent of the person to be killed is often not requested, and that the definition of what is permissible as "euthanasia" is broadening daily...
...Last year, the practice of euthanasia took another Great Leap Forward...
...This decision is based on prior case law and the conditions listed previously...
...Admiraal calls euthanasia "the ultimate act of care for the dying...
...But the one person most identified with the cause of Netherlands euthanasia is the aforementioned Dr...
...A leading advocate of euthanasia is Mrs...
...He is also the most disliked by the pro-euthanists, who say they are considering a libel suit against him for allegedly fabricating material concerning euthanasia abuses...
...Blockage of the duodenum occurs fairly frequently in newborns and an operation to remove the blockage almost always proves successful (mortality is about 3 percent), yet the doctor's only regret was that he didn't actively euthanize the child with a hypodermic...
...This is followed by a drug resembling curare (arrow poison), which causes death in ten to twenty minutes by paralyzing the respiratory muscles...
...I can live with the rules of today...
...As to comatose patients, she allowed that "if they've been comatose a long time and there is little hope of recovery, that's okay...
...The KNMG and others criticized the judgment as too harsh, with the president of the KNMG declaring, "I fear that this judgment can lead to euthanasia practice again being drawn into the sphere of secrecy...
...continue to far outstrip the consumer price index...
...A "right to die" bill has appeared in Illinois, and in November Washington state voters will have a chance to make theirs the first state to legalize euthanasia...
...Regarding Alzheimer's disease, "We realize there will be demented patients by the tens of thousands...
...The core of the argument is that people are the creation of God and do not have the right to determine about their own living, about ending it...
...At some point thereafter, he would send the patient to the sick bay where, regardless of the patient's medical condition, he would administer a huge amount of sedatives...
...They also think the United States is particularly vulnerable to widespread Dutch-style killing of the old and infirm...
...Euthanasia in the Netherlands "Active" euthanasia, the active killing of a patient at his request by a physician, is illegal in the Netherlands...
...One poll conducted by questionnaire through a variety of newspapers in 1986 showed that 33 percent of the Dutch are sympathetic to the idea of active euthanasia, that 43 percent want to take action in the case of comatose patients, and that 27 percent think that they might request euthanasia for a senile member of the family...
...We realize that we cost the community a lot...
...It was also translated into English...
...What if euthanasia were requested years earlier in the event of a hypothetical situation...
...In 1973, a doctor who had put her terminally ill mother to death with morphine received a suspended sentence of a week in jail, plus a year's probation...
...Thus, despite the talk of euthanasia being voluntary, van der Sluis says, "Euthanasia doctors will kill you with yourconsent if they can get it, and without your consent if they cannot...
...A 1986 poll has been interpreted to show that 76 percent favor the practice...
...Consequently, it is impossible for people who do not want euthanasia to be maneuvered or forced into it...
...Sutorius goes even further to state that it is a "dangerous threat to society the moment physicians themselves withhold treatment on non-medical grounds, citing societal needs, etc...
...I wonder if this isn't a transient phenomenon...
...But both the Dutch Society for Voluntary Euthanasia and Admiraal support disconnecting the feeding tubes of comatose patients in some circumstances, a practice Admiraal defends on both economic and humanitarian grounds...
...One inquiry among hospital patients showed that many fear their own families may ask for euthanasia without consulting them...
...Retired Michigan pathologist Jack Kevorkian set up a device in a van in Portland, Oregon, that an Alzheimer's victim used to kill herself...
...Typically, the patient will be given an injection of a strong dose of barbiturates that causes unconsciousness within three to five seconds...
...This doctor is the only one in the Netherlands ever to serve jail time for his euthanasia activities...
...Even after 100 Dutch physicians were sent to concentration camps, the medical profession would not give in...
...I think pro-lifers must be very afraid of dying...
...But another survey indicated that 81 percent of the family doctors polled had done it...
...The Dutch criminal code provides for 12 years' imprisonment for anyone who "takes the life of another at his or her explicit and serious request...
...This, he says, was after he had repeatedly tried to get her to go to a nursing home...
...A piece of the organization's literature shows a bear climbing into a comfortable-looking coffm, complete with fluffy pillow and a caption reading, "You should give me the right to die as a gentleman...
...After fifteen years, it's no longer an experiment...
...Of those living independently, 47 percent opposed euthanasia, as compared to 97 percent of nursing home residents...
...Is Euthanasia for the Patient or Society...
...The charges were dismissed because the act of euthanasia fell within the criteria developed by the High Court, namely that the disability, although not fatal, was incurable...
...Mrs...
...An opinion poll showed that 70 percent of the public approved of Voute's actions...
...But call it what you will, says Fenigsen, people are putting others to death who did not explicitly ask for it, and they are doing so because they feel they can get away with it...
...In practice, however, the term "unbearable" is so vague that it would be virtually impossible to prove that any doctor who claimed it applied had actually violated the requirement...
...Bakker just isn't very concerned about abuses, whether because she doesn't really be-lieve they have been happening or will happen or simply because she thinks even addressing the subject distracts from the good fight...
...He was, however, disciplined by the medical authorities, who imposed a fine but allowed him to keep his license...
...The editors of the Report countered: "In our tenure as editors, no manuscript has been subjected to more sustained scrutiny...
...He warns, "Don'tspeak of the Dutch experiment...
...He must take the initiative, asking specifically for euthanasia rather than merely wishing aloud that he were dead, something many of us do on occasion without the expectation that someone will subsequently plunge a lethal syringe into our arm...
...Another, not a doctor, who has written extensively on the subject, is a self-proclaimed lesbian...
...Letter after letter to the Hastings Center Report objecting to the Fenigsen article relied on semantics, saying, in briefest form, that since "involuntary euthanasia" is a contradiction in terms, there is therefore no involuntary euthanasia in the Netherlands...
...The result, as Attorney General T. M. Schalken stated in 1984, is that "elderly people begin to consider themselves a burden to the society, and feel under an obligation to start conversations on euthanasia, or even to request it...
...A man of 61 with a beard and large belly, he looks a bit like Burl Ives with glasses...
...The Christian Democratic Party (CDP), which has a majority of seats in parliament, is the most strongly anti-euthanasia of the major parties...
...Bakker appears content to keep her crusade within national boundaries, Dr...
...As soon as euthanasia is [statutorily] legalized, we believe illegal things will be far easier to detect...
...An American commentator, Patrick G. Derr, notes: German medicine required fewer than 20 years to make the transformation [to where widespread euthanasia of "undesirables" was accepted...
...In his torment, the wounded man begs his comrade to shoot him...
...Woman in Coma Wins Right to Die," ran the bizarre headline in Denver's Rocky Mountain News...
...If too tight, it will be ignored and if too wide the right-wing Christian party will not accept it...
...When he actually reached that level, however, he changed his mind, declaring vociferously that he had no wish to die...
...Fenigsen says such a cultural bias has to be taken into account whenever one considers how voluntary "voluntary" euthanasia is...
...Sven Danner of the Amsterdam Medical Center, which treats 75 percent of Netherlands AIDS patients, reports that one in eight AIDS patients receives euthanasia, but there is no reason to believe 18 THE AMERICAN SPECTATOR OCTOBER 1991 that this percentage would apply to people with other illnesses...
...Nevertheless, Dr...
...Now," he says, "the world knows me as the first strong advocate of euthanasia...
...According to one hospital director with terminal patients, Dr...
...In the spring of 1988, the KNMG published the first part of a report called wkrminating Life in Incompetent Patients," which stated that about 300 newborn babies have their lives ended every year, though usually they are just allowed to die...
...One survey taken in 1985 and 1986 found that 48 percent said they had received at least one request for death...
...Thus, 18 percent of the doctors responding had performed euthanasia...
...22 THE AMERICAN SPECTATOR OCTOBER 1991...
...I really think that [by then] we may accept that, for purely economic reasons, they can stop life after a period of three years of complete dementia, for instance...
...Will it soon be a duty to kill...
...The KNMG has reformulated its position to include all three conditions...
...Fenigsen, writing in the Wall Street Journal, stated that the Standpoint on Euthanasia proposed by the Dutch Royal Society of Medicine was unanimously rejected by the Committee on Medical Ethics of the European Community, and this body expressed "hope that this strong reaction will induce the Dutch colleagues to reconsider their move and return to the happy communion of utmost respect for human life...
...Gunning says, "There are people who exploit the humanitarian views of the public" to support their own utilitarian purposes...
...The former clearly feel they have less risk of being involuntarily killed...
...That the Netherlands should be in the forefront of euthanasia today is ironic, considering the resistance of Dutch doctors to German attempts at euthanasia during World War II...
...A majority of the State Commission on Euthanasia also supports involuntary euthanasia for persons who have irreversibly lost consciousness...
...Admiraal sees himself as an internationalist...
...In fact, the child withered away over a period of two horrible weeks...
...The police then report to the district attorney, who decides whether to prosecute...
...While Mrs...
...The world is changing...
...In theory, eitherthe physician or the coroner must report to the police that the killing has taken place...
...We're not going to spend energy to work against murder," she says...
...But what of children far below the age of 15, in whom mature judgment is objectively impossible...
...Recently, these wills have begun to be replaced by small plastic cards...
...Gunning doesn't question the sincerity of the pro-euthanists...
...The right of self-determination is one of our highest goals," says Mrs...
...Killing" is his word...
...We can estimate that by 2020 or 2030 there will be the highest [proportion] of old people and the smallest amount of young people the world has ever known," Admiraal told the Los Angeles runes...
...In France," he says, "they don't trust the state or even lesser authorities...
...Performance of euthanasia remains limited to doctors, although a physician can request the help of a nurse...
...But, as noted, many Dutch favor euthanizing comatose patients...
...Admiraal...
...Bakker notes that euthanasia was common in Roman times...
...The doctor was arrested and put into jail...
...One of the roots of [modern-day euthanasia] is that physicians treat too long...
...According to one doctor, J. H. Segers, the results of a 1984 survey indicate that "a request for . . . euthanasia often disappears when there is good supportive care and a good combating of the symptoms of the disease...
...The Netherlands Pharmaceutical Society offers doctors a booklet of drug combinations that Dr...
...J. Michels, euthanasia requests from his patients are extremely rare...
...sometimes parents can have an immature judgment," concluded a ICNMG white paper released in 1986...
...It is notable that neither of the last two categories involves the patient's consent...
...The conditions it specified were that (1) the patient be incurably ill, (2) the patient be experiencing unbearable suffering, (3) the patient request the termination of his life, and (4) the patient's physician perform the euthanasia...
...Much of the evidence of involuntary euthanasia is anecdotal, for obvious reasons...
...Gunning, there are two branches of ethics regarding euthanasia...
...Pit M. Bakker, president of the 45,000-strong Dutch Society for Voluntary Euthanasia...
...The only American visitor to the Netherlands that I discussed it with thought—I'm not kidding —that it concerned therapy to keep people youthful-looking...
...He is in such great demand, between his telephone and his beeper, that a reporter who wants to speak to him for 30 minutes is advised to schedule at least a few hours in his office...
...In 1981, the number of people carrying such cards was reported to be 30,000, but they have yet to catch on, numbering perhaps 45,000 today...
...One said he approved of it, "if somebody was sick and said he wanted Anti-euthanists are united by the belief that euthanasia as now practiced will lead to an ever-expanding definition of what is allowable...
...Either an injection or the hospital...
...Yet even these proposals are limited compared to what actually goes on in the homes and hospitals of the Netherlands...
...At trial they were found guilty only of acting without the guidance of a doctor...
...Bakker...
...There are mixed opinions in the Netherlands on whether euthanasia is gaining ground elsewhere...
...Ah, that's a very tough issue...
...I never see pro-lifers except in America," he says...
...Leo Alexander, a member of the Office of the Chief Counsel for War Crimes in Nuremberg, "it came about that not a single euthanasia or sterilization was recommended or participated in by any Dutch physician...
...The Dutch Voluntary Euthanasia Society also supports the euthanization of newborns...
...This would give a national figure of 3,000...
...A new edition of this how-to guide was published in 1980 by the Dutch Euthanasia Society and sent to all practicing physicians in the Netherlands...
...A group of physicians has broken off from the KNMG to form the Dutch Physicians League, loudly alleging that certain doctors dispose of patients almost on whim...
...This is the image the Netherlands euthanists like topresent of their craft: "He was in horrible pain and about to die anyway and so, with great reluctance, I helped him to accomplish that which he could not do himself...
...One of his fellow soldiers has been horribly injured, clearly beyond recovery...
...The prosecutor can then contact the police...
...After a moment of silent bewilderment on her part, he added: "All right, I will be back within an hour...
...In Fenigsen's defense, it must be said that after an article by him appeared in the Hastings Center Report, the most prestigious American journal of medical ethics, angry letters from important pro-euthanists questioning Fenigsen's veracity flooded the journal...
...One doctor confessed to killing five patients, explaining that his actions had been justified because patients had, as much as four years earlier, made such remarks as "I do not want to become a vegetable...
...In fact, it may be that a euthanasia statute would make illegal euthanasia easier to deal with in the same way abolishing laws against shoplifting would make that crime easier to deal with—namely because it wouldn't be a crime anymore...
...The inability of such small children to speak for themselves appears to put them in the legal position of comatose adults...
...Admiraal notes, in principle "the courts are never against you" if you commit euthanasia...
...This is a priceless possession which we cannot afford to tarnish, but society always is attempting to make the physician into a killer—to kill the defective child at birth, to leave the sleeping pills beside the bed of the cancer patient .. . In the Netherlands, society appears to be succeeding...
...Upon discovering that his unit has been overrun by Communist soldiers he makes an even more horrifying discovery...
...Most of the authorities I spoke with threw their hands up in the air when I asked them how many acts of euthanasia were committed yearly, although Dr...
...Fenigsen notes that, in his entire career of over thirty-five years, he has received only one request for euthanasia, made in a brief moment of despair...
...A controversial "60 Minutes" broadcast in 1986 said that as many as one-sixth of all deaths in the Netherlands could be from euthanasia, about 20,000 people per year...
...In each such case, however, the higher court has overturned the guilty verdict on appeal on the grounds that the doctor acted out of "higher necessity...
...Philippe Schepens, a Dutch physician residing in Ostende, Belgium, has written that "it is extremely important to know what is happening there because from the Netherlands it is slowly spreading across the borders...
...Second, the patient must consider his condition to be unbearable...
...I'm dying to go," it might not be so voluntary as it appears...
...The Hiding Place Foundation has recently printed a "life declaration," a small document to be carried on one's person stating that the undersigned does not wish to be euthanized...
...Some Dutch supporters of euthanasia are adamant that the act is always voluntary, or at least should be, and that actions to the contrary are abuses of an otherwise valid system...
...A 1988 article in Issues in Law & Medicine, citing an estimate of the Central Medical Inspection of National Health, said that euthanasia is being carried out at least 6,000 times per year in general medical practice [huisartsenprate* is the term used...
...It is telling that this concern over having too wide a law had nothing to do with the possibility of allowing involuntary euthanasia, only in getting it passed...
...Van der Sluis quotes a general practitioner who said: "There are different kinds of families...
...Awareness of euthanasia in the Netherlands seems high...
...Nevertheless, an activist judiciary has rendered the statute essentially meaningless...
...Kevorkian will soon attempt to make it onto the bestseller lists with his new book Prescription: Medicide...
...If one adds to that the hospitals, nursing homes, and medical specialists, then we are talking about as many as 10,000 to 12,000 cases of euthanasia per year...
...Yet even when a patient makes so clear a statement as, "Please kill me...
...Thus, in 1975, the Commission on Medical Ethics of the Health Council advised that, for newborns, both active and passive euthanasia should be permissible under certain conditions...
...A project undertaken in a Rotterdam nursing home provides evidence for this, according to Segers...
...One commentator notes that this means, "A more objective medical check of this experience is necessary to avoid extremely subjective requests...
...Some will do almost anything to help the sick man, nursing him at home, often going to incredible lengths, but there are also families that want to make a clean sweep...
...The Democratic and Labor parties are pro-euthanasia, and so is even a major element of the CDP...
...The Netherlands Patients Organization works to alert sick people and their families that in many hospitals people are being killed without their consent or knowledge, without even the knowledge of their families...
...Many court cases have also cited as requirements the presence of an incurable disease or the demand that the patient's death not inflict unnecessary suffering on others...
...They are young and a little bit blind...
...The right to terminate one's own life is considered simply the flip side of the right to keep one's life—an aspect of individual autonomy...
...He has come eight times to preach the cause to the US., which he feels is somewhat reactionary...
...In the few cases that have been brought to trial, the court has sometimes declared the doctor guilty but has not imposed punishment...
...Who Commits Euthanasia...
...As a result of such actions, the Dutch Patients' Association placed an advertisement in the press saying that in many hospitals patients are being killed without their or their families' will or knowledge...
...The 1987 proposal put forth by the government's general health council would allow the termination of people who are (1) not terminally ill, (2) not incompetent, and (3) less than 16 years old—without parental knowledge or consent...
...One is "humanitarian," and says euthanasia is to be performed solely for the alleged benefit of the euthanized...
...In practice, the use of this procedure is extremely rare...
...Thus, in the same conversation in which Dr...
...The highest terms of praise have been applied to the request to die: This act is "brave," "wise," and "prognzsive...
...And I took away that picture...
...Indeed, euthanasia is so accepted and supported by the establishment that one prosecutor in Alkmaar openly works forjudicial widening of the scope of euthanasia laws...
...They feared too soon...
...After the Amsterdam University Hospital nurses were arrested, the victims' parents thanked them at an emotionally charged televised ceremony, providing additional evidence that what Fenigsen In explaining why he wrote a how-to book on euthanasia, Dr...
...Euthanasia opponents Catharina Dessaur and Chris Rutenfrans cited the example of one doctor relating to another the incident of a child born with Down's syndrome who had blockage of the duodenum...
...But even before a Rochester grand jury decided on July 26 not to indict Dr...
...Some say they support it but they refuse to practice it...
...Another letter mentioned "the 1985 definition of the State Commission on Euthanasia that euthanasia refers to all actions aimed at deliberately terminating a person's life at his or her explicit and voluntary request...
...Humphry is executive director of the Hemlock Society, a Eugene, Oregon-based group that promotes euthanasia, and his new book, as is now well known, is a how-to manual for suicide...
...The Dutch physician is not allowed to attribute the death to "natural causes" on the death certificate...
...By employing additional personnel and taking other steps, it was possible to devote extra care to patients whose death was near...
...Most are Christians, but all are united by the belief that euthanasia as now practiced is unnecessary and will lead to an ever-expanding definition of what is allowable...
...A few years ago, three nurses at the Free University Hospital of Amsterdam killed several comatose patients without any form of consent...
...Often we notice that we are being talked into desiring death...
...Ideally, they are both cheaper and homier than hospitals...
...Thus, wrote the late Dr...
...Pieter Admiraal, an anesthesiologist at the de Graaf hospital in Delft who himself carries out euthanasia, proffered a guess...
...Of elderly people opposed to euthanasia, 60 percent of nursing home residents expressed fear that they would be involuntarily euthanized, while 24 percent of those living independently expressed that fear...
Vol. 24 • October 1991 • No. 10
