Explanatory text on the Dutch Euthanasia Bill 
November 2000 

Euthanasia bill will be under dicussion on 21, 22 and 23 November 2000 in the Dutch Lower House of Parliament and shall be put to the vote on 28 November 2000. 

The Minister of Justice and the Minister of Health have tabled a legislative proposal in the Lower House of Parliament for the ‘review of cases of termination of life on request and assistance with suicide’. A provision is to be included in the Netherlands Criminal Code whereby the termination of life on request and assistance with suicide would not be punishable if certain criteria of due care are fulfilled. The bill is a consequence of the coalition accord that led to the formation of the present government (a coalition of Labour and two Liberal parties). 

Special grounds for exclusion from criminal liability

The two conditions under which a physician will not be liable to criminal prosecution are: 1. The physician must have fulfilled the requirements of due care as laid down in a separate act, namely the Termination of Life on Request and Assistance with Suicide (Review) Act; 2. The physician must notify his or her actions to the municipal coroner in accordance with the relevant provisions of the Burial and Cremation Act. 

The inclusion in Section 293 (2) and Section 294 (2), second sentence, of the Criminal Code of a special criminal liability exclusion provision will not in any way affect the liability to punishment of other forms of termination of life on request and assistance with suicide. As such, the general proposition that euthanasia and assistance with suicide are no longer punishable offences is not a correct representation of what the bill is designed to achieve. 

Present notification procedure

Under the rules as they stand at present, termination of life on request is a criminal offence, but no prosecution is brought if certain criteria of due care have been fulfilled. The tests applied are that the patient should have made a voluntary, well-considered and lasting request, that the patient was faced with a future of unremitting and unbearable suffering, that a second physician was consulted and that the termination of life was carried out in a medically appropriate fashion. Physicians are also under a duty to notify the authorities after a case of termination of life. The actions of the physician are then assessed by a regional review committee to ensure that due care was observed. Finally, the opinion of the review committee is submitted to the Public Prosecutions Service, which accords great weight to it in deciding whether criminal proceedings should be brought. 

Requirements of due care

The new statutory rules will not make any substantive changes to the grounds on which life may be terminated on request or on which assistance with suicide are permitted. The requirements of due care have however been formulated in somewhat more detail. Under Section 293 (2) of the Criminal Code the physician must: 
a. be convinced that the patient’s request was voluntary, well-considered and lasting; 
b. be convinced that the patient was facing unremitting and unbearable suffering; 
c. have informed the patient concerning the latter’s situation and prospects; 
d. have reached the firm conclusion with the patient that there was no reasonable alternative solution to the patient’s situation; 
e. have consulted at least one other independent physician, who has examined the patient and who has formed a judgment concerning the requirements of due care as referred to in a-d above; 
f. have carried out the termination of life in a medically appropriate fashion. 

Regional review committees

The five regional review committees will continue to exist under the new bill, but their role will be different. They will continue to assess whether a case of termination of life on request or assistance with suicide fulfils the due care criteria. If the committee considers that the physician has acted with due care, the case is closed. Only where this is not so is a case referred to the Public Prosecution Service. Naturally, the Public Prosecution Service has the power to institute an investigation itself where there is suspicion that a criminal act may have been committed. 

Euthanasia declarations

Finally the bill includes express recognition of the validity of written declarations of wishes about the termination of life (known as euthanasia declarations). A physician may act on the basis of such a declaration, while observing the other criteria of due care, unless he or she has good reason not to do so. An example of the latter would be further advances in medical science and technology since the declaration had been made. Fears of serious side-effects may for example be superseded. Another well-founded reason would be that the declaration was not clear enough.