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country profile
NLAssisted Dying in The Netherlands 
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The Netherlands was the first country in the world to legalize assisted dying and remains the global reference point for a fully integrated, medicalised end of life framework.
Legal Status: Legal
The practice is governed by the Termination of Life on Request and Assisted Suicide (Review Procedures) Act (2002).
Key Legislation The Euthanasia Act (2002)
Supplemented by the Groningen Protocol (2005) for infants and the 2024 Regulation for children aged 1-12.
Eligibility
Access is available to adults and minors (with specific age-based rules) who reside in the Netherlands and suffer unbearably with no prospect of improvement.
Summary
As the pioneer of assisted dying, the Netherlands has the most mature and extensively studied system in the world. Since 2002, medical assisted and voluntary assisted dying have been decriminalised, provided they are performed by a physician who adheres to strict “due care” criteria.
Unlike the “voluntary assisted dying only” models found in the US or Switzerland, the Dutch model is predominantly medical administration, which accounts for over 96% of cases. The system is unique in its breadth: it allows for advance directives (for dementia), covers psychiatric suffering (under very strict scrutiny), and, as of 2024, covers children of all ages.
Quick Overview
In the Netherlands medical assisted and voluntary assisted dying are criminal offences under articles 293 and 294 of the Dutch Criminal Code. The only exception is when the procedure is performed by a doctor who has satisfied six statutory due care criteria. These criteria are laid down in the Termination of Life on Request and Assisted Suicide (Review Procedures) Act. The doctor is also required to notify the municipal pathologist.
Termination of Life on Request and Assisted Suicide (Review Procedures) Act (2001) (EN)
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Termination of Life on Request and Assisted Suicide (Review Procedures) Act (2001) (Dutch)
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The Dutch system operates on a “trust but verify” basis. Doctors are not required to get prior approval from a committee (unlike in Spain). Instead, they perform the procedure and report it afterward to one of the five Regional Euthanasia Review Committees (RTE).
The RTE reviews every case to ensure the six “due care criteria” were met. If the criteria were followed, the doctor is immune from prosecution. In 2024, the RTE reviewed nearly 10,000 cases, finding that doctors acted with due care in almost all instances. The system is deeply integrated into the General Practitioner (GP) network, with GPs performing the majority of procedures in the patient’s home.
Visit De Einder (Federation Member)
for more info.
Nederlandse Vereniging voor een Vrijwillig Levenseinde (Federation Member)
for more info.
Stichting de Vredige Pil (Federation Member)
for more info.
History and Legislation
The Netherlands did not legalize assisted dying overnight; it was the result of 30 years of judicial transparency.
The “Postma Case” (1973): The debate began when Dr. Truus Postma was prosecuted for ending her mother’s life. The court gave her a symbolic sentence, establishing that a doctor’s duty to relieve suffering could, in extreme cases, override the duty to preserve life.
Dementia (2020): The Supreme Court confirmed that a written advance directive is valid for patients with advanced dementia who can no longer communicate.
Children 1-12 (2024): In February 2024, the government implemented a regulation allowing euthanasia for terminally ill children aged 1-12. This closed a legal gap between the Groningen Protocol (infants <1) and the 2002 Act (minors >12), making the Netherlands the second country after Belgium to allow pediatric euthanasia for all ages.
Who is Eligible?
The Dutch law is broad but rigorous. Eligibility requires:
- Residency: While not explicitly banned for foreigners in the text, the medical guidelines require a long-term doctor-patient relationship. In practice, this makes “medical tourism” impossible; doctors do not treat patients they do not know well.
- Adults: Full access.
- Minors: Must be terminally ill (death expected in short term), suffering constant physical pain (psychological suffering alone is excluded for minors), and have parental consent.
- Condition:
- Unbearable Suffering: The suffering must be “unbearable and with no prospect of improvement.” It can be physical or psychological (psychiatric cases require a second opinion from a specialist).
- No Reasonable Alternative: The patient and doctor must agree there is no other reasonable solution.
- Age Groups:
- Adults (18+): Full access.
- Minors (16-18): Full access, parents must be consulted but cannot veto.
- Minors (12-16): Allowed with parental consent.
- Children (1-12): Allowed for terminally ill children with hopeless suffering (under 2024 regulation).
- Infants (<1): Allowed under the Groningen Protocol.
- Advance Directives: A written request is legally valid if the patient becomes incompetent (e.g., dementia), though doctors often exercise extreme caution in these cases.
Members
Our Dutch Members
We currently have 63 are members of the World Federation, with 3 based in The Netherlands.
latest news
The latest news from our members and from around the world
Our members produce helpful factsheets and newsletters. The Federation is always happy to share other sources of information in favour of our joint mission to advance assisted dying around the world.
