Death on demand? An analysis of physician-administered euthanasia in The Netherlands

Physician-administered euthanasia (PAE) was legalized, along with physician-assisted suicide (PAS), in The Netherlands in 2001.

Annual reports of the Dutch Regional Euthanasia Review Committees, the committees' 2015 published Code of Practice and research studies.

There is a general openness about the practice of PAE/PAS in The Netherlands and an avoidance of misleading euphemisms. The 2001 law also includes arrangements for post-event review of PAE/PAS decisions.

Rising numbers of annually reported deaths from PAE and uncertainty over actual numbers. Movement away from the principle that euthanasia must take place within an established doctor-patient relationship. Increasing extension of the 2001 law to people with mental health conditions, dementia and multiple co-morbidities. Nature of the post-event scrutiny applied to reported cases.

The predominance of PAE over PAS where both are legalized raises questions over how these two acts are perceived and whether there are implications for such laws.

Are the criteria for PAE/PAS in the 2001 law appropriate for a law of this nature? What should be the respective roles of the second-opinion doctors and the review committees?