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Patient Autonomy and the Defence of Medical Necessity: Five Dutch Euthanasia Cases
Open accessAbstract
In the Netherlands, physicians are allowed to practice euthanasia pursuant to medico-legal guidelines established by the Dutch Supreme Court. The Court has in effect carved out a defence of medical necessity for physicians who would otherwise be convicted of Penal Code offences that are likewise found in the Canadian Criminal Code. The Dutch euthanasia policy, or EAS (euthanasia and assisted suicide), applies to both consensual lethal injection and assisted-suicide scenarios. The Dutch policy is grounded in the bio-ethical principles of patient autonomy and beneficence. The law stipulates that the request for death must be the voluntary choice of a mentally competent patient whose suffering is unbearable and irremediable. This article discusses the application of these principles in the context of five Dutch EAS cases. The cases illustrate how a commitment to autonomy/beneficence can lead to a broadening of the patient-centred criteria which would justify a physician in taking active steps to end life.
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Case analyses from the Netherlands describe patients who endured prolonged illness and multiple failed interventions prior to approval for MAiD, rather than social inequities.
“Case analyses from the Netherlands describe patients who endured prolonged illness and multiple failed interventions prior to approval for MAiD, rather than social inequities.23”
From Medical Assistance in Dying for the Sole Underlying Condition of Mental Disorder (MAiD MD-SUMC): an analysis and qualitative evidence synthesis (2026) · cites this paper as [23]
The case accounts describe prolonged suffering and unsuccessful treatment for some patients: the Kors account reports sixteen years of treatment without improvement, and the Duintjer account describes a long psychiatric history and various treatment regimens. But the Commentary describes Chabot’s patient as not having a long-standing psychiatric disorder, and the case account says she declined antidepressants and bereavement therapy—not that multiple interventions had failed. The Conclusion discusses inadequate care and financial pressure as risks to the medical-necessity defence, rather than establishing that social inequities played no role in the cases (case passages indexed under ‘C. THE CASE OF DR. KORS (PAEDIATRICIAN)’; VIII. COMMENTARY; IX. CONCLUSION; page numbers unavailable). (LLM, conf=0.88)
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Cohen‐Almagor, R. (2002) · The Journal of Law Medicine & Ethics · doi:10.1111/j.1748-720x.2002.tb00725.x · Cited by 16
White, B. P., Willmott, L., Villar, K. D., Hewitt, J. E., Close, E., Greaves, L. L., Cameron, J., Meehan, R., & Downie, J. (2022) · University of New South Wales law journal · doi:10.53637/fyid9182 · Cited by 7
Euthanasia and Assisted Suicide in the Post-Rodriguez Era: Lessons from Foreign Jurisdictions
Cormack, M. (2000) · Osgoode Hall law journal · doi:10.60082/2817-5069.1494 · Cited by 5
Pawluk, A., Arksey, E., Jansens, H., Qiao, S., & McFarlane, L. (2026) · BMJ Open · doi:10.1136/bmjopen-2025-105129
Lewis, P. J. (2012) · Cambridge University Press eBooks · doi:10.2139/ssrn.2636312
The Practice of Euthanasia and The Legal Framework
(2008) · Springer eBooks · doi:10.1007/978-1-4020-2251-7_3
Kayacan, D. N. (2022) · European Union and its neighbours in a globalized world · doi:10.1007/978-3-031-04516-5_3
Bioetyka i prawo. Między autonomią, życiem i śmiercią a sprawiedliwością w opiece zdrowotnej
Łaszewska-Hellriegel, M. (2026) · Wydawnictwo Uniwersytetu Łódzkiego eBooks · doi:10.18778/8445-087-1
Metadata
- Authors
- Sneiderman, B., & Verhoef, M.
- Venue
- Alberta Law Review
- Publisher
- University of Alberta Libraries
- Published
- 1996-02-01
- Volume
- 34
- Issue
- 2
- Pages
- 374
- ISSN
- 0002-4821 (ISSN-L)
- 1925-8356
- OpenAlex
- W2417149788
- Cited by
- 8
- References
- 0
- Citations by year
- 2026: 1 · 2022: 2 · 2012: 1
- FWCI
- 0.00
- Type
- journal article
- Language
- en
- Open access
- diamond
- doi.org
- Locations
- Alberta Law Review (publishedVersion)
- PubMed (publishedVersion)
- DigitalGeorgetown (Georgetown University Library) (submittedVersion)
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Ethics and bioethics in healthcare
- Social Sciences › Law › Medical and Health Sciences Research
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Palliative and Oncologic Care
- Keywords
- euthanasia, assisted suicide, patient autonomy, beneficence, Dutch Supreme Court, criminal liability of physicians, lethal injection, bioethical principles, comparative criminal law
- MeSH terms
- Altruism, Chronic Disease, Criminal Law, Depressive Disorder, Pharmaceutical Preparations, Euthanasia, Freedom, Disabled Persons, Persons with Disabilities, Homicide, Humans, Jurisprudence, Motivation, Netherlands, Physician-Patient Relations, Physicians, Public Policy, Quality of Life, Societies, Stress, Psychological, Treatment Refusal, Liability, Legal, Suicide, Assisted, Guidelines as Topic, Personal Autonomy, Beneficence, Euthanasia, Active, Mentally Ill Persons, Persons with Psychiatric Disorders, Euthanasia, Active, Voluntary
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