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J R Soc Med. 1996 February; 89(2): 61–63.
PMCID: PMC1295657

Euthanasia: going Dutch?


My experience in 25 years as a hospice doctor have reinforced my belief that when everything is taken into account--physical, psychological, social and spiritual--euthanasia is not the answer. This belief is enhanced by what I see happening in the Netherlands. However, lest it be thought that I have become hardened and indifferent to suffering let me add that, although firmly opposed to euthanasia, I consider that: (i) a doctor who has never been tempted to kill a patient probably has had limited clinical experience or is not able to empathize with those who suffer (ii) a doctor who leaves a patient to suffer intolerably is morally more reprehensible than the doctor who performs euthanasia A doctor has twin obligations to preserve life and to relieve suffering. Preserving life is increasingly meaningless when a terminally ill patient is close to death, and the emphasis on relieving suffering becomes paramount. Even here, however, the doctor is obliged to achieve his objective with minimum risk to the patient's life. This means that treatment to relieve pain and suffering which coincidentally might bring forward the moment of death by a few hours or days is acceptable (the principle of double effect), but administering a drug such as potassium or curare, with the primary intention of causing death, is not.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.
  • Walton J. The House of Lords on issues of life and death. J R Coll Physicians Lond. 1994 May-Jun;28(3):235–236. [PubMed]
  • Heintz AP. Euthanasia: can be part of good terminal care. BMJ. 1994 Jun 25;308(6945):1656–1656. [PMC free article] [PubMed]
  • Van Der Maas PJ, Van Delden JJ, Pijnenborg L, Looman CW. Euthanasia and other medical decisions concerning the end of life. Lancet. 1991 Sep 14;338(8768):669–674. [PubMed]
  • van der Wal G, Dillmann RJ. Euthanasia in The Netherlands. BMJ. 1994 May 21;308(6940):1346–1349. [PMC free article] [PubMed]
  • Hendin H. Seduced by death: doctors, patients, and the Dutch cure. Issues Law Med. 1994 Fall;10(2):123–168. [PubMed]
  • Spanjer Marjanke. Mental suffering as justification for euthanasia in Netherlands. Lancet. 1994 Jun 25;343(8913):1630–1630. [PubMed]
  • Spanjer Marjanke. Nurses cannot assist suicide in Netherlands. Lancet. 1995 Apr 1;345(8953):849–849. [PubMed]
  • Zylicz Z. The story behind the blank spot. Hospice in Holland. Am J Hosp Palliat Care. 1993 Jul-Aug;10(4):30–34. [PubMed]

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