The Dutch ethics professor who changed his mind on euthanasia – Noted

Expanding euthanasia

Boer, who teaches at the Protestant Theological University in Groningen, is concerned that the choices people are making are changing the way they view the process of dying.

There is a societal move to equate dignified dying and orchestrated dying. They think that the only dignified death is one that you have caused yourself or that your doctor has caused. That concerns me because killing a human being is, and should be, an exception.

We shouldnt pretend that killing a human being whose natural life is not ended is normal. That is certainly not the view of Dutch doctors they continue to stress that it is emotionally very burdensome to do euthanasia.

Two recent court rulings are offered by Boer as evidence that euthanasia laws, no matter how tightly crafted, will inevitably be loosened. In a landmark court case in the Netherlands, a doctor was charged with murder for her role in euthanising a woman with dementia who had requested to be euthanised if she needed to go into care. Despite a sedative being slipped into her coffee, the woman roused as the lethal drug was about to be administered and she was held down by her family as the doctor completed the procedure. Judges said the doctor acted lawfully as not carrying out the process would have undermined the patients wish.

Boer says the implications are far reaching. The court has said that if a patient has made an advance directive and the patient has severe dementia that her advance directive trumps her present expression [of what she wants to happen].

The patient fought back; the court has ruled it was okay to put a sedative in her coffee in order to try to prevent her realising what is going on. It brings a lot of trouble to doctor-patient relationships because we expect there will be pressure now, from relatives, on gerontologists and nursing-home physicians to euthanise people who are incompetent. It is likely to be appealed and it should go to the High Court.

Seymours bill is narrower than Dutch law and would allow euthanasia only for terminally ill people with less than six months to live. Although Boer says that is superior to Dutch law, he cautions it is hard to accurately predict life expectancy for the terminally ill.

More importantly, Boer contends the six-months-to-live criterion is arbitrary. Limiting assisted suicide and euthanasia to patients with half a year to live or less isnt that a grave injustice to patients with similar suffering, who say their lives are unbearable, but who have longer to live?

In Canada [where there has been euthanasia for three years], a Quebec court deemed the criterion of terminal illness to be unconstitutional. Two patients with chronic illnesses challenged the law and the court ruled it is unconstitutional to limit the law to the terminally ill.

Both the Dutch and Canadian verdicts illustrate that if you have a euthanasia law, it will expand. It is an absolute certainty that, if New Zealand accepts Mr Seymours bill, it is not a matter of if but when the first court cases will start in which chronically ill patients fight against the limiting [of the law] to the terminally ill.

Boer also points to a bill drafted by the D66, a coalition partner in the Netherlands Government. The partys Completed Life Act, if introduced and passed, would allow people over the age of 75 to access euthanasia regardless of their physical health. The reason why this is being brought forward is that this is a group of people who might suffer from meaninglessness, detachment and loneliness.

This law would send two signals: one would be positive we respect your autonomy but the second signal frightens me, that there are groups of people in society we can do without. And this comes as we in the Netherlands, and in your country, campaign to prevent suicide.

What does Boer hope to achieve by visiting New Zealand in the latter stages of debate on the End of Life Choice Bill? Is his message primarily that New Zealand is on a slippery slope, as he contends has happened in his homeland?

Im not so fond of the slippery slope, but you can see from the different countries that have legalised euthanasia that there is a systemic injustice in limiting it to terminal patients. People are bound to challenge this, but I dont call it a slippery slope because you end up being called a scaremonger, and Im not. I just want to be realistic and I think New Zealanders should make informed decisions.

Even if they end up in favour of euthanasia, it should not be because of a naive romanticism about how well it goes in the Netherlands.

This article was first published in the September 28, 2019 issue of the New Zealand Listener.

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The Dutch ethics professor who changed his mind on euthanasia - Noted