Tuesday, August 09, 2005
New Dutch Euthanasia Study a Whitewash
From ABC News
Although some very positive spin is being applied, the internal inconsistencies and omissions of this latest report on Dutch euthanasia raise more questions.
A study released Monday sheds new light on euthanasia in the Netherlands, the first country to legalize it for terminally ill people, finding that nearly one in eight adult patients who requested mercy killings decided not to go through with it. Nearly half of the euthanasia requests were carried out.
The study comes at a time of heightened scrutiny of euthanasia especially in the Netherlands, where officials acknowledged last year that they had carried out mercy killings of terminally ill newborns.
Belgium has since enacted a euthanasia law similar to the Netherlands. In the United States, Oregon is alone in allowing physician-assisted suicide, but its law is expected to be argued before the U.S. Supreme Court this fall.
The study, appearing in Monday's Archives of Internal Medicine, consists of a survey completed by 3,614 Dutch general practitioners who were asked to describe the most recent request for euthanasia they received during the previous year.
According to another story on the report which was sponsored by the Royal Dutch Medical Association there was this brief mention of guidelines:
In the Netherlands, euthanasia is restricted to terminally ill patients suffering unbearable pain with no hope of improvement, and who request to die when they are of sound mind.
These guidelines were established by the RDMA. Yet the results show that euthanasia in practice does not follow the guidelines:
Project leader Bregje Onwuteaka-Philipsen said she was surprised that "the most important reasons for doing the request are not strictly medical." The survey asked physicians the reasons that patients sought help in ending their own lives, with the most frequent being pointless suffering, loss of dignity and weakness.
The report does mention that some requests were denied for similar reason, but the medical guidelines are being ignored by a large percentage of the reporting physicians. I've mentioned in previous posts that there are serious problems with reporting in Dutch euthanasia cases:
Before 1991 it was difficult to obtain facts about the incidence of euthanasia in Holland, because the KNMG had chosen a very narrow definition of the word. The Dutch officially define euthanasia as the ending of the life of one person by another at the first person's request. If life is ended without request, as it often is, it is not considered to be euthanasia and therefore official statistics have always been lower than actual numbers. For example, Dutch doctors, for obvious reasons, prefer not to use the term "involuntary euthanasia" but call it the more sanitized "termination of the patient without explicit request". Dr. John Keown, an English legal scholar, has commented on this redefinition, "By narrowly defining euthanasia as referring only to "active voluntary euthanasia" rather than to all cases in which death is brought about on purpose as part of the medical care given to the patient, the Dutch minimize the frequency with which death is "intentionally accelerated by a doctor."
The Remmelink Report found that almost 40% of deaths in Holland are due to "medical decision at end of life", but only a fraction of these are reported. This latest study which is basically the RDMA's report card on it's own guidelines ignores all of these issues. Obviously a more objective study is needed. The sad fact is that most euthanasia legislation is being craft along the lines of the Dutch experiment which has been misrepresenting the results for decades.
Although some very positive spin is being applied, the internal inconsistencies and omissions of this latest report on Dutch euthanasia raise more questions.
A study released Monday sheds new light on euthanasia in the Netherlands, the first country to legalize it for terminally ill people, finding that nearly one in eight adult patients who requested mercy killings decided not to go through with it. Nearly half of the euthanasia requests were carried out.
The study comes at a time of heightened scrutiny of euthanasia especially in the Netherlands, where officials acknowledged last year that they had carried out mercy killings of terminally ill newborns.
Belgium has since enacted a euthanasia law similar to the Netherlands. In the United States, Oregon is alone in allowing physician-assisted suicide, but its law is expected to be argued before the U.S. Supreme Court this fall.
The study, appearing in Monday's Archives of Internal Medicine, consists of a survey completed by 3,614 Dutch general practitioners who were asked to describe the most recent request for euthanasia they received during the previous year.
According to another story on the report which was sponsored by the Royal Dutch Medical Association there was this brief mention of guidelines:
In the Netherlands, euthanasia is restricted to terminally ill patients suffering unbearable pain with no hope of improvement, and who request to die when they are of sound mind.
These guidelines were established by the RDMA. Yet the results show that euthanasia in practice does not follow the guidelines:
Project leader Bregje Onwuteaka-Philipsen said she was surprised that "the most important reasons for doing the request are not strictly medical." The survey asked physicians the reasons that patients sought help in ending their own lives, with the most frequent being pointless suffering, loss of dignity and weakness.
The report does mention that some requests were denied for similar reason, but the medical guidelines are being ignored by a large percentage of the reporting physicians. I've mentioned in previous posts that there are serious problems with reporting in Dutch euthanasia cases:
Before 1991 it was difficult to obtain facts about the incidence of euthanasia in Holland, because the KNMG had chosen a very narrow definition of the word. The Dutch officially define euthanasia as the ending of the life of one person by another at the first person's request. If life is ended without request, as it often is, it is not considered to be euthanasia and therefore official statistics have always been lower than actual numbers. For example, Dutch doctors, for obvious reasons, prefer not to use the term "involuntary euthanasia" but call it the more sanitized "termination of the patient without explicit request". Dr. John Keown, an English legal scholar, has commented on this redefinition, "By narrowly defining euthanasia as referring only to "active voluntary euthanasia" rather than to all cases in which death is brought about on purpose as part of the medical care given to the patient, the Dutch minimize the frequency with which death is "intentionally accelerated by a doctor."
The Remmelink Report found that almost 40% of deaths in Holland are due to "medical decision at end of life", but only a fraction of these are reported. This latest study which is basically the RDMA's report card on it's own guidelines ignores all of these issues. Obviously a more objective study is needed. The sad fact is that most euthanasia legislation is being craft along the lines of the Dutch experiment which has been misrepresenting the results for decades.
papijoe 6:53 AM
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