Wednesday, 11 December 2013

Let's not forget how the Dutch do death by euthanasia

While a great deal of the focus on the euthanasia front is looking at Belgium at the moment, it is worth remembering that The Netherlands created patient killing by doctors long before their near neighbours.


The Dutch reporting system tells the story as Wesley Smith explains (note two of Wesley Smith's blog posts follow together):


How do Dutch doctors kill? Let me count the ways: Dutch euthanasia statistics are bogus. Always were. 

First, they have a very narrow definition of euthanasia and assisted suicide. For example, when a doctor lethally injects someone who didn’t ask to be killed–known as termination without request or consent–it isn’t technically considered euthanasia.

Second, Dutch doctors intentionally overdose patient with pain medicine to cause death–also not considered euthanasia. A new study finds that about 10% of Dutch doctors have killed by intentionally overdosing. From the DutchNews.nl story:
One in 10 Dutch family doctors has given dying patients a too-high dose of morphine or other painkiller in order to speed up their death, the Volkskrant reports on Tuesday. The figures come from a survey of 866 family doctors for NCRV television programme Altijd Wat, the Volkskrant said. ‘If a terminally-ill patient is suffering badly, despite being given the correct medicine, then I give someone as much as I think necessary. Protocols are irrelevant on such occasions,’ one anonymous doctor is quoted as saying.
Notice, consent had nothing to do with it.

Third, Dutch doctors often don’t report their euthanasia deaths even though required by law.

Fourth, doctors increasingly used terminal sedation instead of lethal injection. That is, they put a patient into a coma and withhold food and water. For them, that has the benefit of their not having to be present at the death.

A bit ago, I computed the numbers of patient deaths in the Netherlands that involved killing by doctors at a staggering 13%.

Bottom line: Euthanasia empowers doctors to kill who they think need killing. There is no control or protection other than the consciences of death doctors.


I grow weary of the continual attempts to spin and cover up the depth of the death culture of the Netherlands. For example, recently, articles have celebrated the official 2.8% euthanasia rate. But that doesn't include assisted suicide (0.2) and the fact that 23% of euthanasia deaths are unreported. So, that brings the official count to about 3.5%. [See Update below. The 2.8% included unreported euthanasias, hence, the actual number is closer to 3%. Readers should adjust their math accordingly.] In and of itself, that's huge. In the USA, it would amount to about 84,000 euthanasia/assisted suicides a year (3.5% of 2.4 million annual deaths)! But the doctor killing count in the Netherlands is actually far higher. Terminal sedation is slow motion euthanasia. In TS, the patient is put into a coma and deprived of food and water until death. (This should be distinguished from palliative sedation, a legitimate pain control technique, as I write about here). According to a Lancetreport, 12.3% of Dutch deaths involved continual sedation:

In 2010, of all deaths in the Netherlands, 2·8% (95% CI 2·5–3·2; 475 of 6861) were the result of euthanasia...In 2010, 77% (3136 of 4050) of all cases of euthanasia or physician-assisted suicide were reported to a review committee (80% [1933 of 2425] in 2005). Ending of life without an explicit patient request in 2010 occurred less often (0·2%; 95% CI 0·1–0·3; 13 of 6861)... Continuous deep sedation until death occurred more frequently in 2010 (12·3% [11·6–13·1; 789 of 6861])...Of all deaths in 2010, 0·4% (0·3–0·6; 18 of 6861) were the result of the patient’s decision to stop eating and drinking to end life; in half of these cases the patient had made a euthanasia request that was not granted.

My research indicates that about 2% of terminal cases require palliative sedation, which is not killing because it is done at the very end of life and death comes from the disease, not dehydration. Using that figure, about 10% of Dutch deaths were TS slow motion euthanasia. That raises the killing count to nearly 14%. Now, realize that roughly half of Dutch deaths do not involve end of life medical decision making (e.g. accidents, heart attack, etc.). That makes the count--(very roughly)--25-28% of all deaths in which medical decisions were made about the end of life. (And we are not even discussing intentional morphine overdoses that previous studies show usually go unreported). Now, I think we are on much more realistic ground. The 2.8% stat is clearly bogus. The real number is at least 3.5%, but really closer to 14%. If the USA legalized euthanasia and had a similar killing count, the total number of doctor-administered deaths would be over 300,000 annually! Update:Alex Schadenberg tells me the 2.8 percent included reported and unreported euthanasia deaths. But he also tells me that the 2.8% is wrong. I will link his take on that in a separate post. In any event, my broader point remains the same. The overall kill rate is closer to 13-14% when you include slow motion euthanasia via terminal sedation.

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