In 1991, a debate at the European Parliament on euthanasia stimulated discussion at all levels in Europe. Subsequently, the Board of Directors of the EAPC organised a working session together with two experts to help them clarify the position the organisation should adopt towards euthanasia. The experts collaborated with the Board of Directors on a document and in 1994 the EAPC produced a first statement, Regarding euthanasia, published in the official journal of the EAPC – the European Journal of Palliative Care . In February 2001, the EAPC Board asked an expert group to form an Ethics Task Force to review the subject and advise the organisation accordingly.

https://journals.sagepub.com/doi/pdf/10.1191/0269216303pm673oa

Euthanasia and physician-assisted suicide : a view from an EAPC ethics task force.

Purpose This study examines the proportion of cancer deaths occurring at home in six European countries in relation to illness and to demographic and health care factors. Methods Death certificate data of all cancer-related deaths in 2002 in Italy and 2003 in Belgium, the Netherlands, Norway, England, and Wales (N = 238,216) were linked with regional health care and area statistics. Multivariate binomial logistic regressions were performed to examine factors associated with dying at home. Results The percentage of all cancer deaths occurring at home was 12.8 in Norway, 22.1 in England, 22.7 in Wales, 27.9 in Belgium, 35.8 in Italy, and 45.4 in the Netherlands. Having solid cancers and being married increased the chances of dying at home in all countries. Being older and being a woman decreased the chances of dying at home, except in Italy where the opposite was the case. A higher educational attainment was associated with better chances of dying at home in Belgium, Italy, and Norway (countries where infor...

https://ascopubs.org/doi/pdf/10.1200/JCO.2009.23.2850

Which Patients With Cancer Die at Home? A Study of Six European Countries Using Death Certificate Data

Background: Debates over legalisation of physician-assisted suicide (PAS) or euthanasia often warn of a “slippery slope”, predicting abuse of people in vulnerable groups. To assess this concern, the authors examined data from Oregon and the Netherlands, the two principal jurisdictions in which physician-assisted dying is legal and data have been collected over a substantial period. Methods: The data from Oregon (where PAS, now called death under the Oregon Death with Dignity Act, is legal) comprised all annual and cumulative Department of Human Services reports 1998–2006 and three independent studies; the data from the Netherlands (where both PAS and euthanasia are now legal) comprised all four government-commissioned nationwide studies of end-of-life decision making (1990, 1995, 2001 and 2005) and specialised studies. Evidence of any disproportionate impact on 10 groups of potentially vulnerable patients was sought. Results: Rates of assisted dying in Oregon and in the Netherlands showed no evidence of heightened risk for the elderly, women, the uninsured (inapplicable in the Netherlands, where all are insured), people with low educational status, the poor, the physically disabled or chronically ill, minors, people with psychiatric illnesses including depression, or racial or ethnic minorities, compared with background populations. The only group with a heightened risk was people with AIDS. While extralegal cases were not the focus of this study, none have been uncovered in Oregon; among extralegal cases in the Netherlands, there was no evidence of higher rates in vulnerable groups. Conclusions: Where assisted dying is already legal, there is no current evidence for the claim that legalised PAS or euthanasia will have disproportionate impact on patients in vulnerable groups. Those who received physician-assisted dying in the jurisdictions studied appeared to enjoy comparative social, economic, educational, professional and other privileges.

/pdf/legal-physician-assisted-dying-in-oregon-and-the-netherlands-43ez7len6f.pdf

Legal physician-assisted dying in Oregon and the Netherlands: evidence concerning the impact on patients in “vulnerable” groups

LAW, ETHICS AND MEDICINE Legal physician-assisted dying in Oregon and the Netherlands: evidence concerning the impact on patients in ''vulnerable'' groups

Part I. Definitions: 1. Euthanasia and physician-assisted suicide 2. Intended v. foreseen life-shortening Part II. The Ethical Debate: Human Life, Autonomy, Legal Hypocrisy, and the 'Slippery Slope' 3. The value of human life 4. The value of autonomy 5. Legal hypocrisy? 6. The slippery slope arguments Part III. The Dutch Experience: 7. The guidelines 8. The first survey: the incidence of 'euthanasia' 9. Breach of the guidelines 10. The slide towards NVAE 11. The second survey 12. The Dutch in denial? 13. The Euthanasia Act and the Code of Practice 14. Effective control since 2002? 15. Continuing concerns 16. A right to physician-assisted suicide by stopping eating and drinking? 17. Assisted suicide for the elderly with 'completed lives' Part IV. Belgium: 18. The Belgian Legislation 19. The lack of effective control Part V. Australia: 20. The Northern Territory: ROTTI Part VI. The United States: 21. The United States: Oregon and six other jurisdictions 22. The US Supreme Court: Glucksberg and Vacco Part VII. Canada: 23. The Supreme Court of Canada: the Carter case 24. Canada's euthanasia legislation 25. Conclusion.

/pdf/euthanasia-ethics-and-public-policy-an-argument-against-1ljjp6n1cj.pdf

Euthanasia, ethics and public policy : an argument against legalisation

The Netherlands is the only country in the world in which euthanasia, under narrow-defined circumstances, is legally permissible. Considerable attention has been paid over a number of years to the problem of regulating it and information has been systematically collected concerning actual practice. Therefore the Dutch experience is of interest not only to the Dutch, but to anyone who is considering wether or not to make euthanasia a legal practice. This book is written for a reader without specific knowledge of law. The central focus of the book is on Dutch law pertaining to euthanansia, but it also considers the moral and legal principles that have played a role in the Dutch debate, the available evidence bearing on actual practice and on the effectiveness of legal control. It ends with some reflections on the problem of the 'slippery slope' and the question whether the Dutch experience is 'exportable'. It includes translations of the relevant legislation (including proposed reforms) and of three leading cases. This title is available in the OAPEN Library - http://www.oapen.org.

Helena Alfonsa Maria Weyers

Papers

Euthanasia and Law in the Netherlands