By Richard Egan, researcher with the Australian Care Alliance
The latest annual report on euthanasia and assisted suicide from the Netherlands shows that in 2018 the number of reported deaths by euthanasia decreased – for the first time since legalisation – to 6126 (a 7% decrease from 6585 cases in 2017).
Dutch deaths by euthanasia for 2018 include nine couples euthanased together; two persons with advanced dementia based on an advanced request; 205 elderly people with two or more problems of old age; 67 people with mental illness, including 10 aged between 18 and 40 years; and three children aged between 12 and 17.
This represents 4% of all deaths in the Netherlands in 2018.
This data relates only to officially reported cases of euthanasia and assisted suicide. A more comprehensive picture is provided by the five yearly surveys by Statistics Netherlands on all deaths by “medical end-of-life decision”. The latest data reports on all deaths in the Netherlands in 2015.
In that year there were 7254 deaths caused intentionally by lethal medication – 6672 deaths by euthanasia with a request; 431 deaths by euthanasia with no explicit request; and 150 deaths by assisted suicide.
This represents nearly 1 in 20 (4.93%) of all deaths in the Netherlands.
More than 1 in 10 (10.5%) of all deaths (other than sudden and expected deaths) of 17-65 year olds in the Netherlands in 2015 were caused intentionally by euthanasia or assisted suicide.
For assisted suicide in the Netherlands the doctor is required to be present until death occurs. Attempts at assisted suicide regularly fail to bring about death in the desired timeframe. In these cases, under the Netherlands protocols, the doctor then administers euthanasia drugs. This occurred in between 7% and 13% of cases of assisted suicide in the years 2014 to 2018.
There were 67 cases in 2018 of euthanasia for psychiatric conditions, ten of these cases involved persons aged between 18 and 40 years.
There were 205 cases of euthanasia in 2018 for “a stack of old age disorders” such as vision, hearing disorders, osteoporosis, osteoarthritis, balance problems and cognitive decline. Of these cases 66 involved persons under 90 years of age. The remaining 139 cases accounted for 27.15% of all cases of euthanasia of persons aged 90 years or more.
A further three minors were euthanased bringing the total to fifteen children aged between 12 and 17 years euthanased between 2005 and 2018.
In 2018 nine couples were euthanased together. Case reports are available for one of these couples. The husband had oesophageal cancer. The wife had multiple sclerosis. Her reason for requesting euthanasia at the same time as her husband was “the prospect of having to be cared for entirely by strangers and unable to continue living independently”. While the case reports note that “In the event that partners make a request for euthanasia at the same time, it must be established that the request of one partner has not been influenced or has been prompted by that of the other partner” there is no discussion in the case report on the wife of any efforts being made to explore her fears of being cared for by others.
For a detailed report on seventeen years of legalised euthanasia in the Netherlands readhere.