Developments in euthanasia practice in the Netherlands: Balancing professional responsibility and the patient’s autonomy
Open accessAbstract
In 2015, euthanasia accounted for 4.5% of deaths in the Netherlands, of which 93% were performed by a GP. Historically, a conflict of physician's duties-to alleviate unbearable suffering and at the same time preserve the patient's life-is central to the justification of euthanasia practice in the Netherlands. However, there seems to be a shift towards a greater emphasis on the patient's autonomous wish as the primary basis for euthanasia. This shift has consequences for the role and interpretation of the physician's duties in end-of-life care. This paper aims to describe these developments in euthanasia practice and end-of-life decision-making. We describe important relevant developments and look into the role and the meaning of two dimensions of the concept of 'patient autonomy' regarding end-of-life decisions, in particular, the euthanasia request. We claim that the concept of autonomy 'as a right,' which can be distinguished from autonomy 'as an ideal,' narrows the physician's window of opportunity to offer end-of-life care other than euthanasia.
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The popularity of End-of-Life Clinics, specializing in EAS, has been increasing since their foundation in 2012.
“the popularity of End-of-Life Clinics, specializing in EAS, has been increasing since their foundation in 2012.40”
From “Nothing Hurts Less Than Being Dead”: Psychological Pain in Case Descriptions of Psychiatric Euthanasia and Assisted Suicide from the Netherlands: « Rien ne fait moins mal qu’être mort »: La douleur psychologique dans les descriptions de cas d’euthanasie et de suicide assisté psychiatrique aux Pays-Bas (2020) · cites this paper as [40]
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References 12 · Cited by 73
Research works printed but not linked: 4
- [2]Termination of Life on Request and Assisted Suicide (Review Procedures) Act. [Wet Toetsing Levensbeëindiging op verzoek en hulp bij zelfdoding]. [Internet]; 2002 Available from: http://wetten.overheid.nl/BWBR0032047/2016-07-01 16223080
- [6]Weijers H, Euthanasia. The process of law changing. Dissertation [Euthanasie. Het proces van rechtsverandering. Dissertatie.] Faculty of Law. Groningen: University of Groningen. [Faculteit Rechtsgeleerdheid Rijksuniversiteit Groningen]; 2002.
- [7]Regional Euthanasia Review Committees (RTEs). EuthanasieCode. Den Haag: RTE; 2018.
- [17]Berlin I Liberty. Oxford: Oxford University Press; 2004.
- Authors
- Kouwenhoven, P. S. C., van Thiel, G. J. M. W., van der Heide, A., Rietjens, J. A. C., & van Delden, J. J. M.
- Affiliations
- University Medical Center Utrecht (NL)
- Julius Centre for Health Sciences and Primary Care, University Medical Centre Utrecht, Utrecht, The Netherlands;
- Department of Public Health, Erasmus Medical Centre, Rotterdam, The Netherlands
- Erasmus MC (NL)
- Corresponding author
- Kouwenhoven, Pauline S. C.
- Venue
- European Journal of General Practice
- Publisher
- Informa UK Limited
- Published
- 2018-11-01
- Volume
- 25
- Issue
- 1
- Pages
- 44-48
- ISSN
- 1381-4788 (ISSN-L)
- 1751-1402
- PMC
- PMC6394318
- OpenAlex
- W2899289935
- Cited by
- 73
- References
- 12
- Citations by year
- 2026: 6 · 2025: 5 · 2024: 4 · 2023: 8 · 2022: 10 · 2021: 10 · 2020: 25 · 2019: 5
- FWCI
- 9.52
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- cc-by
- Locations
- European Journal of General Practice (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- EUR Research Repository (Erasmus University Rotterdam) (submittedVersion, other-oa)
- RePub (Erasmus University Rotterdam) (submittedVersion, other-oa)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Utrecht University Repository (Utrecht University) (submittedVersion, other-oa)
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Ethics and bioethics in healthcare
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Palliative Care and End-of-Life Issues
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Palliative and Oncologic Care
- Keywords
- euthanasia, patient autonomy, end-of-life decisions, physician obligations, end-of-life care, euthanasia requests, general practitioners
- MeSH terms
- Decision Making, Euthanasia, Humans, Netherlands, Physician's Role, Physicians, Terminal Care, Personal Autonomy, Patient Rights, General Practitioners
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