Controversy has been stirred by a system of mobile euthanasia units that will travel around the country to respond to the wishes of sick people who wish to end their lives in the Netherlands.
The scheme was started on Thursday and will be sending six specialized teams of specially trained doctors and nurses to the homes of people whose own doctors have refused to carry out patients' requests to end their lives. The launch of the so-called Levenseinde, or “Life End”, house-call units – whose services are being offered to Dutch citizens free of charge – coincides with the opening of a clinic of the same name in The Hague, which will take patients with incurable illnesses as well as others who do not want to die at home. The scheme is an initiative by the Dutch Association for a Voluntary End to Life (NVVE), a 130,000-member euthanasia organization that is the biggest of its kind in the world.
“From Thursday, the Life End clinic will have mobile teams where people who believe they are eligible for euthanasia can register,” Walburg de Jong, a NVVE spokesman, said. “If they do comply, the teams will be able to carry out the euthanasia at patients' homes should their regular doctors be unable or refuse to help them,” he added.
The Netherlands was the first country to legalize euthanasia in 2002 and its legislation on the ‘right to die’ is considered to be the most liberal in the world. But doctors cannot be forced to comply with the wishes of patients who request the right to die and many do refuse, which was what prompted NVVE to develop a system to fill the gap.
The group explained that sick people or their relatives can submit their applications via telephone or email and if the patient's request fulfils a number of strict criteria, the team is then dispatched. Legal guidelines state that the person must be incurably sick, be suffering unbearable pain and have expressed the wish to die voluntarily, clearly and on several occasions.
According to De Jong, the team will make contact with the doctor who has refused to help the patient to die and ask what his or her reasons were. More often than not, he said, the motivations are religious or ethical, adding that sometimes doctors were simply not well enough informed about the law. If the team is satisfied that the patient's motives are genuine, they will contact another doctor with whom they will start the euthanasia process. “They will first give the patient an injection, which will put them into a deep sleep, then a second injection follows, which will stop their breathing and heart beat,” De Jong said.
Every year 2,300 to 3,100 mercy killings are carried out in the Netherlands, although opponents of the practice claim the figure is much higher because many cases are not registered.
The mobile euthanasia plan, which received the thumbs-up from Dutch health minister Edith Schippers in the Dutch parliament, has been met with scepticism from one of the Netherlands' largest medical lobbies. The Royal Dutch Society of Doctors says it doubts whether the “euthanasia doctors” will be able to form a close enough relationship with a patient to make a correct assessment.
But Bert Dorenbos who represents the Dutch Cry for Life campaign group thinks mobile units push the limits of the legislation too far. “It's a crazy idea. It's an excuse for pro-euthanasia people to push their agenda. I think it's a PR campaign more than caring for patients who are suffering. 'Come to our clinic and we will help you die.' They make it sound so easy and simple and it should not be that way.”
But Jan Kuyper, of the Life End Clinic Foundation, said, “We're not trying to push any boundaries here.” He said it was quite possible that the mobile teams would not end up carrying out a mercy killing, either due to medical questions about the case or if doubt is cast on the patient's motives. The NVVE says its teams are expected to receive around 1,000 assisted suicides requests per year.
Eventually the organization expects to deal with about 1,000 cases a year, and say they will not charge the patients. Initially the organization itself will cover the costs, although they're currently in discussions with insurance companies to try and reach an agreement that will allow the mobile euthanasia unit service to be available through Dutch medical insurance.
The anti-euthanasia lobby is furious, branding the mobile euthanasia units “death squads” and accusing the government of not doing enough to enforce the strict medical codes of practice that accompanies the procedure. In neighboring Germany, where mercy killings are strictly illegal, euthanasia opponents were particularly vocal in expressing their outrage at the developments. “This is an inhumane proposal,” said the German Hospice Foundation, while the group Life Rights for Everyone called it a “warped understanding of [the meaning of] autonomy”.
Belgium also legalized euthanasia in 2002, and assisted suicide has been allowed in Switzerland since the 1940s. In the UK there have been discussions about changing the law for many years, and a recent report published by the Commission on Assisted Dying, funded by campaigners who want to see a change in the law, recommended the legalization of euthanasia in the UK.
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