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Jeanne Smits, Paris correspondent

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Dutch report shows euthanasia deaths down slightly in 2018 but on the rise again this year

Jeanne Smits, Paris correspondent

April 17, 2019 (LifeSiteNews) — The latest euthanasia figures in the Netherlands indicate a slight decrease in 2018 as compared with the previous year.

In the first decrease since 2007, 6,126 deaths by euthanasia were reported in 2018, representing four percent of all deaths that year. In 2017, the total was 6,585.

The decrease does not appear to be a strong trend, although commentators have underscored that the slight rise in decisions of non-compliancy with legal requirements for unpunishable euthanasia since 2017 might explain that doctors are becoming more wary about “mercy” killing.

On the other hand, according to NIVEL (Netherlands Institute for Health Services), the first quarterly statistics for 2019 show an increase of nine percent compared with the same January to March period in 2018.

Jacob Kohnstamm, the president of the Regional Euthanasia Review Boards (RTE), called the decrease in 2018 a mere “fluctuation.”

“Since 2007, the number of notifications has been steadily rising. This does not surprise me,” he told the Noordhollands Dagblad.

Kohnstamm, whose nomination as president of the RTE in 2016 prompted criticism because he was formerly president of NVVE (Netherlands’ association for voluntary end of life), says “self-determination” plays an ever larger role in the pattern of euthanasia. In a world without objective morality, choosing the moment you “step out of life,” as they say in the Netherlands, is no longer countered by the idea that God only is the master of life.

This post-war trend is particularly noticeable among baby boomers who are now reaching old age, said Kohnstamm. “250,000 people are at present diagnosed with dementia. Anyone who has seen loved ones wither away might decide, ‘I don’t want to walk that road.’”

In 2018, severe suffering linked to painful illnesses such as cancer and neurological, pulmonary and cardiac diseases accounted for 78.66 percent of the total number of euthanasia acts. Extreme physical suffering was the pretext used when euthanasia first became legal in the Netherlands in 2001.

Slowly, the idea that natural death had to be in sight was left aside, and other justifications for unpunishable euthanasia came ever more to the fore: they now account for roughly 20 percent, one-fifth of all “mercy” killings.

Dementia is a case in point. It started a few years after legalization with what can only be called “preventive” euthanasia on patients who were already diagnosed with a neurodegenerative disease but who wanted to die before becoming incapable of expressing their will. Their numbers have been steadily rising and reached 144 last year. They have been overwhelmingly approved by the Euthanasia Review Boards.

NVVE in particular has been working over the years to establish the point that the 2001 Dutch euthanasia law in no way prohibits euthanasia for patients who have become incapable of freely expressing their will, with these cases being provided for by written declarations before losing that capacity.

Dutch doctors – who make the final decision regarding euthanasia demands – have resisted this type of euthanasia, going beyond the law’s requirements by refusing to kill patients who cannot lucidly make their death wish clear at the moment when lethal drugs are administered.

This is slowly changing. In 2018, two persons whose dementia had progressed so far that they could no longer understand what was happening to them were euthanized. One case is discussed at length in the yearly report that offers a few examples of each of the main case scenarios the RTE evaluates.

In “case 2018-41,” the patient was a woman of between 60 and 70 years old who had repeatedly confirmed with her doctor her written statement of 2013 asking for euthanasia when she would “no longer recognize her near and dear ones, be totally dependent on the care of others and lose her dignity.” Her condition worsened and she was placed in a care facility where she became increasingly agitated and panicked, not being able to express what was wrong with her. Psychiatric illness was not the cause, a specialist said.

Her doctor decided the time had come. Having obtained several opinions confirming his impression, the doctor agreed with the woman’s family to administer euthanasia. He first ordered oral administration of 7.5 mg of midazolam, a powerful sedative, followed by local and general painkillers, because he was afraid that in her state of agitation she would panic when the IV needle was installed.

This euthanasia was deemed totally compliant by the RTE and offers a way out after a similar procedure on a deeply demented old woman that was done without prior sedation went badly wrong as she fought attempts to install an IV needle.

The way is now wide open to the killing of Alzheimer, dementia and other patients who can no longer express their will but who are conscious and nowhere near dying.

As reunions are regularly organized in the Netherlands for pensioners in order to “inform” them about the horrors of dementia and the availability of euthanasia, it can be expected that an increasing number of people will leave written declarations.

Another trend is the number of couples who are euthanized at the same time. Nine couples were involved in 2018, whose cases are screened separately by the RTE. A closer look shows that the illness of the one is taken into consideration in order to evaluate the “hopeless” suffering of the other. Hopelessness is an obligatory ingredient in the euthanasia “mix.” there must be no other medical option.

In the case documented by the report, a woman of 50 to 60 years of age had multiple sclerosis and was looked after by her husband. When he in turn fell ill with treatment-resistant cancer, she decided she did not want to depend on anyone else and they were euthanized together using one double euthanasia pump.

This double euthanasia was also deemed compliant.

Three euthanasia cases involved patients between 12 and 17 years of age; they were also green-lighted by the euthanasia commission.

Euthanasia followed by organ donation is also gaining traction. Seven cases were counted in 2018, in a context where the large majority of euthanasia deaths take place at home and organ recuperation is not possible.

A total of six cases in 2018 were judged non-compliant even after supplementary information had been requested and given by the physicians who administered the lethal injection. In most cases, the non-compliance regards mere details: a doctor leaving his patient before making sure death has taken place; failing to consult another physician according to the legal rules, even if this was to avoid subjecting a psychotic patient to further stress through examinations; failure to get a second opinion when a euthanasia specialist was not convinced euthanasia was the best option, and the like.

While more cases are being transmitted to the judicial authorities, they are most often dismissed and no further action is taken.

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