[Ending a patient's life without a request: time for a good assessment procedure]

Empirical studies have shown that in approximately 900 cases per year, Dutch physicians end a patient's life without his or her explicit request. These cases involve mostly incompetent patients with cancer, but also severely handicapped newborns. In 1994, the Dutch government made it mandatory for physicians to report these cases to the public prosecutor. This policy has not been successful. Every year, only a handful of cases are reported. The regulatory problem has two dimensions: on the one hand, in contrast to euthanasia and assisted suicide, terminating life without a request cannot be legitimised by the national government, notably in view of international aspects. On the other hand, terminating life without a request is legally qualified as murder. However, the murder section in criminal law is perceived to be intended for other cases entirely. One option might be to introduce a separate category in criminal law. The medical profession favours a system in which the reported cases are analysed by a multidisciplinary committee consisting of a lawyer, a physician, and an ethicist. It is expected that such a system would increase the willingness to report cases.