The culture that is Dutch fact of the day

In 2013, euthanasia accounted for one of every 28 deaths in the Netherlands, three times the rate of 2002. In the Dutch-speaking part of Belgium, one of every 22 deaths was due to euthanasia in 2013, a 142 percent increase since 2007. Belgium has legalized euthanasia for children under 12, though only for terminal physical illness; no child has yet been put to death.

That is from Charles Lane.


Good for them. Not every government needs to torture its citizenry.

What could go wrong?

It saves the health delivery system human resources and money.

Cradle to grave.

Next, it will not be a choice. Death panels rule! Serfdom sucks.

It is a fallacy that you can protect liberty by banning liberty.

If you force people to live longer than they want to, you force them to cost more money. But this money could have been better spend on those who actually want to live longer. If nothing else, you undermine other people's quality of life, and the financial sustainability of the healthcare systems.

What portion of these people are incapable of ingesting a drug overdose on their own? I think unassisted suicide was previously legal.

The problem is that by "assistance", they can mean something as simple as giving a prescription.

And none of the good drugs are available without presciption, the best ones not even necessarily then (where I live, sodium pentobarbital cannot legally prescribed for this use).

Yes, you can jump off a high building if you have the courage, and die an extra shitty death, but I don't see how that helps anyone.

Well, some people want to die but minimizing the emotional stress on their families. Last year an acquaintance of my wife had to say farewell to her mother with lung cancer. The woman requested assisted suicide from an NGO and made an appointment 3 months before. During that period, it was farewell time with the family. Unassisted suicide means hiding from everyone else instead of facing death with your family around you.

It's the very same outcome if the dead is caused by morphine overdose, a bullet to the brain, or assisted suicide. However, for the dead there's a difference in selecting calmly when to die and something I've never thought, the dying reach peace of mind if they receive some kind of permission or pardon from their families. They need to listen from the living,"thanks for everything, don't worry, we'll be fine". For the family, there's also a difference, they have time to say goodbye and have the comfort of a non-painful death of their family member.

"And none of the good drugs are available without presciption, the best ones not even necessarily then (where I live, sodium pentobarbital cannot legally prescribed for this use)."

No need for a drug to die totally painlessly.

Its a waste of helium, but helium comes in convenient canisters you can rent at party stores, and if you breathe a high concentration you will expel CO2 and thus suffer no asphyxia, but will die for lack of oxygen, The market needs to supply small canisters of pure nitrogen.

A suicide can be planned and communicated to family and still be unassisted.

And yes "Assisted" can mean a range of things. Where someone besides the the individual doing the dying delivers the killing dose I think we have reached a morally and legally dangerous area. Prescribing someone morphine to go kill themselves with is grayer for me but I lean towards it being okay.

mulp, I tried the helium method 3 times and find myself *psychologically* incapable of suffocating myself to unconsciousness, even if it is without agony.

I would at least want to try pentobarbital, and I don't see how that violates the rights and legitimate interests of other people.

Only the good die young. They're wasting money on 90-year-old Jimmy Crater.

Death panels rule. They need the money for younger patients. The Brits already place older patients on the fast-track to death.

It's about the money. This has nothing to do with liberty. If you have access to a razor blade or a sharp knife, you can kill yourself. Make it easy. Drink a bottle of nice wine, get in the bath tub, run the water and cut your wrists. Why would you need help? Because you aren't ready to die. The government must not license medical professionals to convince/persuade you and also "do" you.

"Next, it will not be a choice."

Why do you think its a "choice" now? Elderly people with dementia are incapable of rational choice.

Their greedy and selfish children and compliant doctors are making the "choice" for most.

How do you know? Did you assume there are no legal and procedural safeguards against this situation now? (There are.) We do care about elderly people with dementia here in The Netherlands, you know.

I know a person who died at age 85 with dignity, surrounded by her children and in her own home, instead of slowly withering away from cancer. Her family would have supported her until the end, but she made this choice, for herself. I think this right is worth protecting. I am thankful that my fellow Durch citizens agree.

How do you know your anecdote is typical?

"We do care about elderly people with dementia here in The Netherlands"

Not too much though. You passed this law after all.

"legal and procedural safeguards"

Paper thin. Easily evaded.

Any evidence to support your claims Bob?

Bob is a conservative who knows that if you never chose to die, you will live forever.

You know, some people with inside information of the health care -- like people who have worked their whole careers as doctors or nurses -- decide ahead of time that they don't want to live in a state where every day is merely being kept alive by a machine with no chance to do anything else but feel pain. And they've written up living wills stating exactly that.

"And they’ve written up living wills stating exactly that."

That is great, everyone can choose what health treatments they will consent to.

Total strawman though, we are discussing laws that permit doctors to kill.

Coming from Ohio I guess you want prison officials and politicians designing machines to kill people and then the government picking people to die at times the government chooses.

The idea that someone should endure torturous misery at the end of their life just because it is "natural" or "God ordained" is just religious bullshit. It's good to see some parts of humanity finally moving past that kind of nonsense.

This. In America we give our pets easier and more dignified deaths than our family members.

I read that link, Dan. It made me wonder, don't people mercy kill their family members in the United States? It's not uncommon here. It's not legal, but to an extent at least it's an accepted part of the culture. Of course, not accepted by everyone. The penalties might range from a five year good behaviour bond, to two years weekend detention, to life imprisonment. However, I have not aware of anyone receiving life imprisonment for what was almost certainly euthanasia.

I read that link, Dan. It made me wonder, don’t people mercy kill their family members in the United States?

No. There are some dubious practices you see in nursing homes and such e.g. withdrawal of feeding tubes.

We have the doctrine of double effect where health providers are allowed to give terminally ill patients enough pain killers to kill them, provided they are not trying to kill them.

what an awful, preachy op-ed. easing restrictions on voluntary euthanasia is a clear positive, both in terms of social ethics and of public policy.

what an awful, preachy op-ed. easing restrictions on voluntary euthanasia is a clear positive, both in terms of social ethics and of public policy.

It's a clear policy to people who are obtuse and know nothing and can imagine nothing of how decisions are actually made in those circumstances.

'a clear positive'

The title of the article is so stupid. It is an inevitable trend, due to the growing health care costs and aging population, and it's HUMAN. If you look at the cases mentioned in the article, they all seem to be justified, although it is in many cases a quite SUBJECTIVE decision. But just because its subjective it does not mean it is wrong. The wrinkle is, that these procedures need to be controlled, reviewed and physicians should be held accountable for errors but this evaluation is quite difficult to do in an objective manner.

It's sinister just because it's legal ;)

Switzerland tolerates assisted suicide since 1942 and there are very interesting numbers. A) From 1995 to 2009, assisted suicide cases have grown but the total number of suicides keeps constant. B) Assisted suicide in 2009 accounted for approx 30% of all suicides. C) Women chose assisted suicide more than men, but men use firearms more than women to commit suicide. D) Peak assisted suicide is between 75 and 84 years old. It seems that people that cross the 80+ years old line are not affected by painful or exhausting diseases thus they choose to life until it ends naturally E) Peak suicide is between 45-54 years old, midlife crisis is real, F) Overall suicide rates for women kept constant even if assisted suicide rates increase. G) Overall suicide rates for men are going down and assisted suicide goes up.

The overall suicide rate in Netherlands between 1999 and 2013 has been between 8.3 and 11 per 100K habitats. The lowest rate was just before the crisis.

The WaPo article would lose its killer headline if the total suicide rate is considered when assessing the "exponential" increase of assisted suicide. This seems like another case of double standards. When someone blows their brains with a gun we have to respect the decision and comfort the family, when someone opens the valve of sodium thiopental with their's just wrong.

All the commenters here sound like they're rehearsing what to say to Mom and Dad when they get inconvenient.

Meh. My parents are already inconvenient, but I have no interest in their suicide, and they would never be swayed by what I have to say on the matter anyway.

But this is a matter of rights. *I* want to be able to buy sodium pentobarbital for *my* personal use, without being harassed by patronizing religioius ideologues.

Try living with dementia or alzheimer and then tell me how fun it was for you and your kids ;)

"dementia or alzheimer"

Such people can make rational, informed decisions?

No, the kids are killing their parents/doctors their patients with the state's encouragement.

"Such people can make rational, informed decisions?"

When Sir Terry Pratchett first revealed his Alzheimer's diagnosis, he was still mentally clear enough to make choices like this one. He discussed the matter at length in public.

But even if you want to have tight restrictions on euthanasia of people with diminshed ability to consent, it does not justify denying this liberty to any other person, e.g. people with cancer.

Its not the public high profile elite that will generally be at risk.

Its the common middle class woman who is "eating up" the kids inheritance who will be the victims.

The State should only sanction taking the lives of murderous criminals.

Way to go, Bob, just ignore my point about the mentally capable people and then follow up with paranoid unsubstantiated claims.

It's not your suffering, am I right?

Bob, this is not the state sanctioning the practice. This is the state getting out of people's private lives. Your views on Big Government and The State could benefit from a little more consistency.

Jan, I don't think Bob is being inconsistent, unless you believe opponents of Big State want to make murder legal.
His concerns seem to be when others make the decision, and other than specific exemptions from murder laws, this is murder.

Personally I think this is a step in the right direction.

TMC, nobody other than the individual dying is making the decision in these cases. And in the case any decision to withdraw life support in the case of a patient being incapacitated are articulated in an advance directive. That's not an order from a doc or a family member.

It's unfortunate there is such widespread misunderstanding about this.

Try living with dementia or alzheimer and then tell me how fun it was for you and your kids

Been there, done that, if it matters to anyone.

That's THE only argument against this and it's total billshit. Show me some evidence this happens and we'll talk.

What evidence would there be?

Exactly maybe Jan is the type of person to walk around saying I badgered my feeble parents to end their lives but just about everyone else isn't that stupid. Let's put it this way if the left was half as curious about making sure that every assisted suicide had consented as vigorously as an undergrad coed consented to sex then maybe I wouldn't be so queasy about left-wing death cheerleading.

Are you kidding? The consent process where this is legal is extremely rigorous! What a terrible argument.

Uh, you ask the people making the decision to end their own lives why, where they got the idea, what the considerations were, etc. This research is easier than lots of other things that have been studied.

But the more straightforward response is that you want to project your own morals onto other people to coerce them into living longer than they would otherwise choose, often in terrible pain and their emotional destruction. This is your definition of freedom I guess..

I think the issue of suicide, and the freedom to commit it, is much more complex than you are making it.

Social attitudes on suicide, the availability of painful vs. non-painful methods of suicide, and a range of other social and legal factors, will impact whether people decide to kill themselves at some point (and not just at the point where their illusion of immortality has been lifted by a terminal illness).

Take one society that views suicide as a pathetic and cowardly act regardless of the circumstances. Take an otherwise identical society that views suicide as an honorable means of escape from horrible circumstances. Which do you expect to have a higher suicide rate? If you can pick up a massive dose of morphine at your corner store in both societies, are you less free in the former than the latter?

"Emotional destruction" is somewhat odd to worry about as a cost of not suiciding, as suicide literally destroys all of your emotions for eternity.

But ultimately I guess I don't care. We're all dead anyway, whether we mass suicide today or hang on as long as possible. Just an interesting diversion as I continue my long and hopeless march towards death.

I'm worrying how to best carry out my parents' wishes, and that some fuckers might stand in the way.

The f!ckers are not going to 'stand in the way' in New York or Virginia. They'll do dubious things and if your name is not on the health care proxy, you cannot do a thing about it.

A robust advance directive goes into as much detail about as many different scenarios as possible. The proxy is sort of a second-best substitute, in my opinion.

Perhaps the concern of coercion by heirs could be dealt with by confiscating the estate of suicides. I think that was done in the past.

One more reason not to invest.

Just curious, as I complete Simenon's Maigret novella The Flemish House: how much encouragement do Walloons give to Flemings to avail themselves of these generous euthanasic opportunities? (With reference also to Simenon's biography, many a Walloon might think many a Flemish death "a good death".)

The Flemish pay for all their benefits so I doubt it

Where welfare states go to die.

Vigorously oppose and openly shut down medical experimentation and research, a messy on straight line process that could lead to pharmaceuticals or procedures to improve the lives of the elderly, ie. a cure for Alzheimers.

Vigorously support the killing of the inconvenient, insulting those who are uncomfortable or oppose.

Kill'em when they are young, kill'em when they are old.

Good point. I haven't looked at numbers, but I predict there is an inverse correlation between the level of a country's animal experiment regulation and the level of regulation on euthanasia.

Derek, your argument would be a little more effective if you injected some knee-jerk hyperbole.

Also, remind me where the Dutch have shut down medical experimentation and research. In fact, a lot of very good studies have come out of the Netherlands because they have a national health system that keeps excellent records on diagnoses, treatment and outcomes. They punch well above their weight in medical research.

On the bright side, it will free up space for the African and Middle East immigrants who will eventually end the practice.

Yes. The Islamofascist state is already in place in the Netherlands, the UK and France. Germany next. That is why Le Pen had to step down. His fight was lost.

Yes, instead of casual fridays we now have burkha fridays In Europe...

Do you get half off drinks now or is it still just free public lashings and beheadings?

Haha. Love it. Now, to be clear, is that the day one can take of her burkha, or the day that everyone must wear a burkha?

Who is talking about now? The failure of Europeans to breed coupled with this type of law and increasing immigration will inevitably mean the immigrants and their children will be the majority in these countries. 20 years or 40 years, it depends.

Look at the laws and customs of the countries where they are coming from. That is the likely future of Europe.

Well, I doubt that euthanizing the very old is going to have much impact on fertility rates.

If anything, reduced pressure from caring for the old and infirm will free up resources for the young to breed.

Less money wasted on ICUs means more money available for child creches. No?

will inevitably mean the immigrants and their children will be the majority in these countries. 20 years or 40 years,
Your math is off. The source countries (e.g Algeria) commonly have modest fertility and the Muslim population in Europe has a low base from which to grow (perhaps 6% of the continent's population). If Europe manages to control immigration, it will be many generations before the comparative fertility of Muslim populations gets them. Europe's problem is cultural and institutional.

"If Europe manages to control immigration"

Of course that will change the future.

Odds of that happening?

Let in the Asians, but not the Malaysians and Indonesians (bad cultures).

“Part of the problem with the slippery slope,” they write, “is that you never know when you are on it.”

Rubbish. Dame Cicely Saunders was telling people 35 years ago they would be on a slippery slope if they listened to people like Derek Humphrey. Her points were not difficult to grasp. The legal system in the Netherlands simply ceased to enforce laws against euthanasia and aided suicide. The legal profession is the locus of crime and decadence in more than one occidental country. If we're going to be killing people, let's take out some members of the judiciary.

To certain categories of religious people, suicide is forbidden.

Yet, many of these religious individuals will still fall prey to, and suffer greatly from, dementia, Alzheimers, frailty, cancer, and other maladies in old age. A permissive suicide law affords no comfort whatsoever to these religious people. They are forced, through no fault of their own, to suffer.

It is clear that a permissive law discriminates and offers unequal treatment on the basis of religion.

Governments must remedy this unequal treatment. The only way out of this legal problem is for the government, without regard to religion, to impose a comfortable death upon all severely ill people.

Most health care dollars are spent on end of life care that adds quantity, not quality to our lives.

If someone feels that their life is unbearable, why should we stop them from ending it?

Most health care dollars are spent on end of life care that adds quantity, not quality to our lives.

Citation needed.


That aside, 24 hour care is expensive. It costs about $130,000 a year in the New York catchment in which I grew up. The people who benefit from it are infirm, depressed, and often wafty (but hardly universally so).


And, while we're at it, cancer treatment is expensive ($300,000 sticker price for the portfolio of treatments necessary to combat mid-stage breast cancer in New York). It's not always successful. You do not know that beforehand.

Because it denies them the opportunity to test their hypothesis.

No, it doesn't. Suicide is a choice.

Has anyone ever considered the implications of the intersection of advanced directives and time-inconsistent preferences?

I wouldn't worry about it. But ask me again tomorrow.

Yes. Jeff McMahan. "The Ethics of Killing."

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