From the WSJ Opinion Archives
OUTSIDE THE BOX

Dutch Courage
State-sanctioned killing comes to the Netherlands.

by PETE DU PONT
Wednesday, April 25, 2001 12:01 A.M. EDT

Attending Physician: "Goedemorgen, Grandmother. You are a very sick old woman. The independent physician and I have reviewed your medical records and we don't believe you're going to get any better. Are you in pain?"

Grandmother: "Yes, I hurt so much I want to die."

Attending Physician: "Did you hear that, Doctor?"

Independent Physician: "I did."

Attending Physician: "Very well. Initial here and hand me the syringe."

And so the Dutch doctor, under the terms of the newly enacted Termination of Life on Request and Assisted Suicide Act, legally kills the grandmother. As the preamble to the statute says, the legislature considers it "desirable to include in the Criminal Code grounds for granting immunity to a physician who . . . terminates life on request or provides assistance with suicide." One death completed, the doctors move on to the next bed.

The act passed the lower house of the Dutch Parliament by a vote of 104-40 in November, and the Senate on April 10 (just as the annual remembrance of the Holocaust was beginning), 46-28. The Netherlands is now the only free nation that permits doctors to kill their patients. (A law in Oregon allows physician-assisted suicide; euthanasia, in which the doctor is the killer, is a step beyond.)

It is an abhorrent concept, with profound moral consequences. Its purpose was chillingly summarized by German cancer specialist Stephan Sahm, who is opposed to the statute: "Where continuing to live is only one of two legal options, everyone who burdens others with his or her continued existence is held accountable."

The act offers immunity to the attending and independent physicians if they follow detailed procedures. The attending physician must "be satisfied that the patient has made a voluntary and carefully considered request" and that "the patient's suffering was unbearable, and that there was no prospect of improvement." The physician must have told the patient this and, with the patient, decided that there is "no reasonable alternative." An independent physician must agree in writing. Then the termination of the patient's life may proceed. A child under 12 must have parental consent. Parents of teenagers need only be "consulted."

The statutory language appears carefully constructed. But the reality is far different. Euthanasia is a proactive government policy in Holland, so the attending physician may merely be the floor doctor on the night shift. Or a senior doctor who has been told by the hospital's management that costs are too high--a likely scenario, as Holland has an expensive government-funded health-care system.

The patient need not sign off on the termination; a nod of the head will do. Or the consent of parents if a child is born with a disability or perhaps is just unwanted. The suffering could be mental and the patient otherwise healthy. If additional medicines could mitigate the patient's suffering, may they be disregarded in calculating its unbearability? And what does "no reasonable alternative" mean? No alternative to death? All of us qualify on that count.

And all the people of the Netherlands are vulnerable. Doctors helped 3,600 patients die in 1995, according to the Dutch Voluntary Euthanasia Society; the New York Times estimates an average of 3,500 such deaths each year for the past decade. A former Dutch senator, Edward Brongersma, a man with no physical or psychological illness, was helped to die by a doctor last year because he believed he was living "a pointless and empty existence." The doctor was acquitted. In fact, no doctor has served time in prison for terminating the life of a patient since the 1970s. Even so, Dutch legislators were worried enough to pass the statute. One cannot be too careful in these matters.

But physician assisted suicide is not the worst of it. A 1991 report by the attorney general of the High Council of the Netherlands concludes that in the previous year 5,981 people had been killed by their physicians without consent. That is 16 people a day. These killings were carried out while the Dutch criminal code made assisting in the death of a person a criminal offense, punishable by 12 years in prison. The new act will open the floodgates and killings will no doubt increase.

As for the future, more than the life of Dutch citizens is at stake. With government encouragement, an attending physician and a syringe of barbiturates will no doubt be available on demand to anyone visiting the Netherlands. But one may not have to travel that far. An Australian doctor is planning to purchase a Dutch-registered ship "and establish an offshore suicide clinic in international waters," perhaps moving from nation to nation, according to the Los Angeles Times.

From the Soviet gulag to the Nazi concentration camps and the killing fields of Cambodia, history teaches that granting the state legal authority to kill innocent individuals has dreadful consequences. Calling it "termination of life on request" does not change its moral repugnance.

The Dutch have changed the equation; life is now, in Dr. Sahm's terminology, "only one of two legal options," and if we choose to live we will be "held accountable." It is a repulsive redefinition of the gift of life.

Mr. du Pont, a former governor of Delaware, is policy chairman of the Dallas-based National Center for Policy Analysis. His column appears Wednesdays.

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