The right to die needn't be a legal minefield
Every year in the Netherlands, doctors end the unbearable suffering of up to 4000 patients.
This isn’t some ultra-modern, ground-breaking voluntary euthanasia policy. In fact, Dutch residents have been afforded the right to die for 35 years.
When I heard that one of the world’s most respected voluntary euthanasia advocates was about to visit from the land of tulips, I jumped at the chance to ask him about the Dutch experience and whether it might work in Australia.
Dr Rob Jonquière chairs the Dutch Medical Association program which arranges a second opinion when a doctor in the Netherlands has a request for voluntary euthanasia.
Contrary to fears among some Australians, he says in the Netherlands there has been no “slippery slope” towards increasingly relaxed euthanasia laws, doctors do not “play God” and there’s no evidence of “death tourism”.
Here’s how their system works...
Patients who believe they are enduring “unbearable and hopeless suffering” speak to their family doctor about voluntary euthanasia. The doctor then prescribes any alternative treatments which might make life more bearable.
When the doctor and patient believe every alternative has been exhausted, one of Dr Jonquière’s team of doctors is brought in to speak with the patient, review the process of alternative treatments and – as much as is humanly possible – determine that the patient is acting voluntarily.
“Under our law, the patient doesn’t have to be suffering from a terminal illness – in fact one Supreme Court ruling determined that the reason for the suffering is not important,” Dr Jonquière says. “Physical suffering is easier to see and prove, but in principle, mental suffering can be just as unbearable.”
In the case of unbearable mental suffering, a psychiatrist is also brought in to review the process.
Review doctors will sometimes suggest further alternative treatments before consenting to voluntary euthanasia.
After the patient has passed away, the procedure is again fully reviewed, with only about 10 doctors (out of 3000 to 4000 euthanasia cases annually) asked to offer further explanation.
Dr Jonquière estimates that about 40 per cent of Dutch doctors refuse voluntary euthanasia requests on religious or other grounds.
“Around 60 per cent say that if they’re asked, they will comply – but make no mistake, they are not playing God.
“It is the most difficult request you can receive as a doctor. Your first reaction is ‘Oh no – please let’s try to find an alternative.”
A crucial safeguard of the Dutch system is the onus on doctors to show strong evidence of a patient-doctor relationship, which Dr Jonquière says reduces the potential for “death tourism”.
“About 85 per cent of euthanasia cases occur with the family doctor,” says Dr Jonquière. “A doctor administering voluntary euthanasia on a foreigner may be prosecuted because it is against the principle of the law.”
On the equally contentious issues of doctors killing patients against their will or patients opting to die due to family duress or a belief that it will be better for others, Dr Jonquière says there are no 100 per cent guarantees. However he says laws already exist around the world, including Australia, to deal with doctors or families found to be acting criminally.
Agreed. And doesn’t the Dutch system sound so considered, sensitive and careful – a far cry from the desperate, illegal and often lonely lengths that patients in Australia must go to if they want to end unbearable suffering and die at the time of their choosing.
As Dr Jonquière says: “My message to politicians in Australia is ‘don’t be afraid to change the law’. No law, on whatever issue, can offer a 100 per cent guarantee.
“If you wait until this is foolproof it will never happen – and you will never help the people who are suffering and deserve the right to voluntary euthanasia.”
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Articles are reproduced courtesy of Adelaide's Sunday Mail.
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