II. Dutch legislation on euthanasia
III. Elements of Dutch culture related to legalization of euthanasia
IV. The use of the slippery slope argument
- The logical slippery slope
- The empirical slippery slope
V. Can the Dutch Euthanasia Law be used as a model by other countries?
Euthanasia is defined as the intentionally termination of the life of a person upon his or her explicit request. Although, in this limited sense, the legislation of active euthanasia, as accepted in April 2001 in The Netherlands, has provoked a lot of debates. It is often said, once voluntary euthanasia has become legal, we will have set foot on a slippery slope that will lead to tolerating other forms of euthanasia, including non-voluntary euthanasia. If true, this is a powerful argument in the battle of those who oppose to the legalization of euthanasia. However, as many facets of the medical practice of euthanasia remain unclear, and no reliable records on the actual practice of euthanasia exist, the power of any slippery slope argument is limited. Experience in The Netherlands may shed light on both sides of the medal.
This paper consists of four parts. First, I explain the laws that control euthanasia in The Netherlands and elucidate the cultural background in which they originated. Second, I examine more closely the argument of the slippery slope and distinguish a logical and an empirical version. Thirdly, I concentrate on whether experiences in The Netherlands justify any concern about the slippery slope argument. Finally, by addressing questions like "Could euthanasia be safely regulated in other countries?" or "Has legalizing euthanasia set off knock-on effects?" I conclude briefly that Dutch experiences certainly justify some caution.
Ever since, euthanasia has been considered ethically unacceptable and in most countries euthanasia is against the law. This is mostly because people face moral dilemmas, such as the question whether euthanasia could be considered to be acceptable as 'mercy killing' to end the life of a terminally ill patient who is suffering from unbearable pain, or whether there exists a moral difference between the case of administering a lethal injection and the case of failing to keep the patient's feeding tube going? Or if it could be morally justified in the case of compassionate motives upon the patient's request? Does euthanasia oppose the religious beliefs that only God has the power to give life and hence only God should take life away, or should human beings have the power to decide when and how they will die?
But in the opinion of pro-euthanasia advocates is it argued that people have the right to end their own lives, especially in the cases where euthanasia is the better alternative compared to dying a slow painful death. The term itself, which is derived from the ancient Greek word 'euthanatos' meaning good death, gives ground to individuals to claim that euthanasia is a way to die with self-respect and dignity. The justification given for legalization always includes autonomy or elimination of suffering and would only be acceptable if limited to the terminally ill, who are suffering great pain and there are safe boundaries for euthanasia to be set.
But although if it is a sufficient justification for euthanasia to relieve pain and suffering, we have to take into account the surveys in the Netherlands and in USA, which illustrate that only three out of ten patients required for euthanasia due to unbearable pain. More frequently the patient's request for euthanasia had their origin in psychological factors, such as depression and anxiety, fear of social isolation, being a burden on family and dislike of being dependent, than pain. Even persons which have their quality of life limited by physical conditions such as incontinence, nausea and vomiting, breathlessness and paralysis could result in requesting for euthanasia. Thus, should these reasons count as a sufficient justification to help a person to die?
Furthermore we have to consider the persons who are mentally incapacitated and could be euthanized without their consent. This leads us to the concern of many people that if voluntary euthanasia would be legalized, it would not be long before involuntary euthanasia would start to happen. This is called the the slippery slope argument, which in other words means, that if we tolerate something relatively harmless today as relieving the pain of the terminally ill patients, we may start a trend that results in involuntary euthanasia and the killing of persons who are felt undesirable.
Experience in The Netherlands where euthanasia has became legal in 2002 may shed light on whether euthanasia inevitably goes from bad to worse, resulting in more cases of assisted suicide under much broader circumstances, in more requests and in misuse of the term 'euthanasia'.
II. Dutch legislation on euthanasia
The debate on the subject of the legalization process of euthanasia in The Netherlands had been triggered by the "Postma case" in the early 1970s (Sheldon 2007). A physician gave a lethal injection of morphine to help her dying mother end her own life upon her repeated and explicit request for euthanasia. The judge imposed Dr. Postma only a short suspended sentence and one year's probation. While the court found her guilty according to the Dutch Penal Code, it also mentioned that the physician could administer pain-relieving medicine, which could even result in the death of the patient, given that the intention of this treatment was the relief from physical pain. This case brought physician-assisted euthanasia out of the shadows of the taboos in a country with strong Christian principles and into the light of legal and social discussion.
Since then the debate on euthanasia has progressed vigorously and interest in physicians' end-of-life decisions spread around in the Netherlands. By the 1980s the Dutch courts began to adopt a more tolerant attitude concerning doctor- assisted-euthanasia and euthanasia for terminally-ill patients. However, in the view of the Health Council it was crucial that a 'State Commission' should be introduced in order to draw a precisely definition of euthanasia along with the establishment of certain guidelines under which the attending physician should not be prosecuted. Euthanasia has been therefore defined as "intentionally terminating another person's life at the person's request" (Griffiths 1998: 69). Additionally, the Commission drew up a set of criteria for due care which need to be met in each case euthanasia is to be performed (Griffiths 1998: 71).
The Dutch government wanted to make a report about the actual medical practice of euthanasia and assisted suicide, and in 1991 a commission had been established, with the person in charge Prof. Jan Remmelink. The so-called Remmelink Report opened the eyes of the people about the actual practice of euthanasia by Dutch doctors. According to Remmelink 49,000 of 130,000 deaths in the Netherlands each year involved a "medical decision at the end of life" (Griffiths 1998: 78). In other words euthanasia, in the narrow Dutch definition, has been practiced in 2,300 cases or 2% of all deaths in The Netherlands. A second report on the practice of euthanasia in The Netherlands for the year 1995 was published. The number of cases of euthanasia had raised from 2,300 to over 3,000, which represents a 30% increase in less than five years (Griffiths 1997: 78).
However, these alarming statistics did not changed anything in the legal status of euthanasia. Twenty years of policy interference helped to boost the public acceptance of euthanasia from nearly 50% in 1966 up to 90% in 1998 (Griffiths 1998: 198). Another factor that played a significant role in the opinion of Griffiths is the shift in the composition of the Dutch governing coalition, so that in 2001 the government decided to allow euthanasia.
The Euthanasia Act came into effect on April 1, 2002 consisting of regulations on the ending of life by a physician upon the explicit request of a patient suffering unbearable pain. It states that the attending physician cannot be punished if he or her acts in accordance with the criteria of due care. This means when dealing with a patient’s request for euthanasia, doctors must observe six due care criteria. (de Haan 2002). They must:
- Quote paper
- Elena Belle (Author), 2011, Is there any evidence from the Netherlands euthanasia expierience that legiliying euthanasia creates a slippery slope?, Munich, GRIN Verlag, https://www.grin.com/document/184736