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ANALYSIS

May 5, 2016 (LifeSiteNews) – Euthanasia statistics for 2015 have been released in the Netherlands, showing a significant increase of 4 percent as compared with 2014. The rise is mainly due to the increase of euthanasia for demented, elderly people as well as psychiatric patients, two categories that raise even more questions than “ordinary” euthanasia for untreatable physical pain.

In 2015, 109 demented persons (against 81 in 2014) were killed while still “mentally competent” enough to express their own will. 56 patients with psychiatric disorders were put to death at their own request in 2015, a sharp rise from the 41 such cases recorded in 2014. In this last category, the End of Life Clinic was involved in most cases. Out of a total of 5,561 reported euthanasia acts – compared with the 3,695 reported five years earlier – four were deemed not to be in compliance with the Dutch euthanasia law. Two of them were handled by the End of Life Clinic. But no legal action will be taken, reports the protestant conservative daily, Trouw.

In both cases, doctors appointed by the End of Life Clinic were faulted by the regional euthanasia supervisory commission for not having acted in compliance with the full criteria of the law. This would normally open the way for a penal process to be opened against the offender. By deciding not to act, the competent authorities appear to be retroactively justifying certain forms of illegal euthanasia – this is exactly how the “slippery slope” concept works.

In the Netherlands, euthanasia, the deliberate killing of a human being – supposedly at his or her request – is in principle a penal offense. Compliance with a “strict” list of criteria, which include “unbearable suffering,” the lack of alternative therapy, and “no possibility” that the patient’s situation will improve, allows doctors to escape both trial and punishment. But they are expected to report all acts, with a wealth of details, for them to be vetted by one of the five regional euthanasia supervisory commissions.

Once the commission has studied the case it either passes it as compliant with the law or transmits it to the Health Inspection Service and to the public prosecutor. These can then decide whether or not to open a judiciary procedure.

Over the years, the regional commissions have accepted more and more dubious cases as legal, so when they decide not to “pass” an act of euthanasia as compliant, further investigation by a court would appear to be essential.

Not so, decided the Health Inspection and the public prosecutor in two cases that did not make the grade in 2015.

It must be said that the End of Life Clinic was founded in 2012 precisely to handle cases where ordinary doctors are unwilling to accede to a patient’s request, in a context where euthanasia is not a patient’s right and where the physician always has the last word. Conscientious reasons or a decision about the depth of suffering of the person who is demanding to be killed can lead a doctor to refuse or to put off a euthanasia act. The End of Life Clinic is there to “help,” with a team of counselors who can intervene to make the doctor change his or her mind, and also specialized “flying death squads” who are prepared to procure euthanasia in the comfort of the patient’s home.

The two cases for which End of Life Clinic’s doctors were singled out involved psychiatric suffering and advanced dementia.

An old woman who had suffered from repeated episodes of depression over several decades was killed in 2015 without the End of Life Clinic having consulted an independent psychiatrist, contrary to the guidelines of both the Netherlands Association for Psychiatry and the medical association KNMG. Talks with the depressed old lady were conducted by an “in-house” geriatrician only, even though the End of Life Clinic’s own affirmed objective is to help people obtain euthanasia.

The End of Life Clinic argued that the patient had had “bad experiences” with psychiatrists, which is why it decided to bypass the obligation that exists because of the difficulty to determine whether a psychiatric patient’s death wish is “sincere and lasting.” The competent regional commission did not accept the excuse, pointing out that geriatricians are simply not competent to judge euthanasia requests in these situations.

Both Health Inspection and the public prosecutor decided to accept the consultation because the persons involved in the decision were “convinced” that the old lady really wanted to die. Besides, the End of Clinic promised to handle cases differently in the future. That was deemed sufficient.

In the second case, a similar promise made by a doctor who had killed a very old demented lady on the faith of a twenty year-old “living will” also ensured that he went scot-free. In his report to the euthanasia commission, he pointed out that he did not personally think that his patient was suffering “intolerably,” a statement that he later qualified when questioned by Health Inspection saying his first declaration had been “incomplete.”

The decades-old “living will” made clear that the patient, who was then mentally competent and perhaps not even ill, preferred to die rather than to be placed in a specialized institution. The “living will” was never updated and therefore a doubt subsisted, twenty years on, whether she really wanted to be put to death, with no way of knowing her actual will.

Both Health Inspection and the public prosecutor refused to act on the euthanasia commission’s decision not to consider this euthanasia as compliant with the law.

Even so, new guidelines were published in January of this year by the KNMG, the Ministry of Justice and the Ministry of Public Health in the Netherlands, saying – quite vaguely – that “living wills” should not be “too dated.” The fact that the Justice Ministry’s own services have decided not to prosecute in the aforementioned case show the guidelines are being considered as mere indications. Last year, a similar case was shelved by the public prosecutor when a patient suffering from Huntington’s disease and almost incapable of communicating was killed on the faith of a six year-old euthanasia request.

However lax Dutch euthanasia commissions have become, the judiciary in the Netherlands always appears to be prepared to go one step further.