Hastened Departures

Under the judicial doctrine of “original understanding,” there is no doubt that capital punishment is constitutionally permissible. However, this does not mean that there are no prudential reasons against the use of this irreversible punishment. Regardless of the fact that guilt is determined by a jury of one’s peers in an adversarial hearing, regardless of the availability of modern forensic DNA tests, and regardless of all the procedural safeguards that can take years to pay out, it is still possible that the innocent may be killed. Once a person has been executed, there is no recourse if we later decide that the sentence was incorrectly applied.  Given human imperfection in making even protracted life-and-death decisions, it appears wholly irrational to go blithely along like the Netherlands believing that doctors can decide which lives are worth living and which are not.  The procedural safeguards to prevent the unnecessary death of presumed criminals in the United States appear enormous compared to the feeble protections afforded the terminally ill in the Netherlands.

When euthanasia [1] became legally sanctioned in the Netherlands, the promise was that such “mercy” killings would be performed only upon a patient’s thoughtfully-considered request and consent.  The patient was to be completely informed about his prognosis. In addition, the physician in charge must be convinced that the patient’s suffering is unbearable.

It turns out that over time, these safeguards have radically eroded, if indeed they were ever more than perfunctory.  A 1991 Dutch study found that 6,000 people had been killed without explicit request or consent for euthanasia.  These deaths account for about 4% of the deaths in the Netherlands [2].  Some people have requested death and had their request honored while not terminally ill, but while suffering from severe depression or suicidal inclinations.  There is one known case in the Netherlands of a despondent gentleman with the HIV virus having been euthanized even before symptoms of full blown AIDS had appeared.

There is no reason to believe that the Dutch are a particularly heartless or uncompassionate people.  It is just that the natural tendency of bureaucracies is to make life easy for themselves. Severely ill people are an emotional and financial burden both to doctors and their families.  It is little wonder that euthanasia has extended far beyond the extraordinary cases proponents originally argued they would be limited to.

The problem is complicated by socialized medicine in the Netherlands.  There are limited alternatives, especially among those with average economic means, to opt out of the choices offered by government health care.  It is bad enough when one has to struggle with parsimonious medical providers to have them cover this or that condition. Imagine what could happen, if there were implicit financial incentives to hasten the permanent departure of patients.

It is not just a question of setting up a well-structured system for euthanasia.  Even if the natural human tendency to rid ourselves of inconveniences could be overcome and even if one could, in spite of the evidence, erect enough procedural safeguards so that euthanasia is performed only upon fully competent, emotionally stable, informed, terminally ill patients, euthanasia as a public policy is still unwise and immoral. Given modern palliative measures pioneered by many hospices, there is almost no reason that people cannot be made comfortable in their last moments.  Hospices, too few of which are available in the Netherlands, have specialized in making deaths both less painful and more dignified.  Hospices allow for a death at home surrounded by loved ones rather than in the clinical setting of a hospital.

The path of euthanasia in the Netherlands can not be said to have descended down a slippery slope.  Rather, the system has fallen precipitously over a cliff.  Now, Groningen University in the Netherlands has established the “Groningen Protocols” for the euthanasia of terminally ill children who, we are assured, are suffering unbearably [3].  The protocols apply to infants and children up 12 years old. One shutters at how quickly this is likely to turn into the elimination of children who are a little too disabled, a little too retarded, or a little too imperfect.  If experience with adult euthanasia is any measure, disabled infants in the Netherlands are in mortal danger.

It is not clear just how much input will be allowed parents under these protocols.  Will they have a veto over euthanasia or will they just be consulted?  What choices might desperate parents have if the state-provided health care system refuses the expensive palliative and rehabilitative measures appropriate for their child?

Perhaps the best that can be said of the euthanasia experiment in the Netherlands is that it provides empirical evidence as to just how dangerous any such system inevitably and insidiously becomes. If the ethical senses of the Dutch can be dulled to the point where life can be casually disposed of with nary a shrug, then the moral astuteness of any people can be corroded under such a regime of death.


  1. Technically euthanasia also includes the cessation of extraordinary medical treatment.  When we use the term here, we refer to active euthanasia.
  2. Wesley Smith, “We ignore the Netherlands at our own peril,” National Review, December 18, 2000.
  3. Hugh Hewitt, “What the Groningen Protocol says about our world, and where it might lead next,” The Weekly Standard, December 2, 2004.

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