The right to die
On 10 April, the Dutch Senate voted 46 to 28 to legalise euthanasia. The proposal had already passed the lower chamber of the States General with a 10440 vote in November 2000. On both occasions, the proposal was defended by two liberal ministers: Els Borst of Health (D66) and Benk Korthals of Justice (VVD). The proposal was supported by parliamentarians of D66 and VVD, their socialdemocrat coalition partner PvdA and the Green Left party.
Internationally, the law faced a storm of criticism. Politicians from around the world criticised the law. The Vatican likened Dutch doctors to 'Butchers' after they had compared the Netherlands to Nazi Germany on an earlier occasion. Many German doctors and politicians drew comparisons to the Naziregime as did one Dutch senator of the conservative Christian Union party.
Let's do away with the Nazis first. The Nazis killed mentally and physically handicapped people as well as ethnic minorities and others because they were considered too inferior to be allowed to live. The word Euthanasie has become so tainted in the German language that it has been replaced by Sterbehilfe. Nevertheless, there are no legal or political similarities between NaziGermany in the thirties and the Netherlands today. None. Certainly, no one thinks Reichskanzler Adolf Hitler is in any way comparable to Prime Minister Wim Kok. The way the Nazis abused the German medical profession is tragic and heartbreaking but has no bearing upon Dutch reality today. To say that this law is a slippery slope towards the atrocities of the Nazis is a travesty that does injustice to both Dutch and German history. The Nazis gave the state the right to kill. Dutch parliament has given citizens the right to end their life, under carefully defined conditions.
The Right To Life
More serious criticism of the Dutch law was that it would be contradictory to international treaties that stipulate the right to life. The right to life is a duty on the part of the state to refrain from murder and to provide help and care. I would argue, however, that the right to life is not to obligation to go on living as long as medical science can keep one alive. Freedom of religion does not mean an obligation to be religious. Freedom of expression is not an obligation to have an opinion.
Religious objections against this law are that life begins at the moment of conception, ends at the time of natural death and can only be taken by God. The fact of the matter is that few Dutch people are religious nowadays. The teachings of religion have been replaced by the individual conscience. The law respects freedom of religion and gives the individual the choice in these difficult matters. What Dutch legislators have refused to do is impose the views of a religious minority on a secular majority.
It?s My Life
The Dutch legislation is based on a fundamental liberal principle. It is not the state that decides about an individual?s life. It is certainly not the church of any persuasionthat can take these decisions. When it concerns life and death, the ultimate power rests with the individual.
The Dutch law states 6 criteria for patients of 16 years or older: the request of the patient has to be voluntary and well considered; the patient?s suffering has to be unremitting and unbearable; the doctor has to inform the patient of his situation and prospects; the doctor and patient together have reached the conclusion that there is no reasonable alternative; the doctor has to consult at least one other physician; and, finally, the procedure has to be carried appropriately.
This means that the choice of euthanasia is not an easy one nor one that can be taken lightly. The doctor has to have a long term relationship with the patient. There have to be clear and irrefutable medical reasons. And the patient has to make this choice voluntarily and unambiguously.
Ultimately, if a patients is dying and faces months of pain, that patient can choose to die.
It is an illusion to think that euthanasia happens only in the Netherlands. In many countries, doctors decide to refrain from further treatment or to disconnect breathing apparatus. This is often called ?passive euthanasia?. The next step is to stop feeding a patient or to dehydrate. How often people are actually given painkillers or lethal injections is unknown but there is no doubt that it happens.
The Dutch Again...
There appears to be a fundamental gap between Dutch legislators and their colleagues in many countries around the world. Dutch legislators, led by the liberals of VVD and D66, work on the basis that every human being is a competent, educated, intelligent individual. The Dutch tend to assume that individuals are capable of making their own choices, also in complicates issues such as euthanasia. Dutch government and parliament do not base their work on the premise that the citizen needs the guidance of the state in complex moral issues. Rather, it is the other way around. The state needs to accept moral guidance from its citizens.
This article originally appeared as a column in issue 41 of the Liberal Aerogramme, the magazine of Liberal International, June 2001.
