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Euthanasia in Europe: The Netherlands, Germany, Austria, Switzerland and England. November 20th, 2023
Europa
The ECtHR (European Court of Human Rights) recognizes the right of an individual to determine how and when his or her life ends, as one of the aspects of the right to respect for private, family and family life (Article 8 ECHR, European Convention on Human Rights). The requirement is that the person concerned has been able to make a reasonable assessment of his interests. According to the ECtHR, once suicide is a fundamental right, the inviolability of human life can no longer be a reason to prohibit end-of-life assistance and only the protection of the right to life (the person’s interest in survival) remains as a rationale for criminalization. However, within the ‘margin of appreciation’, each state may determine for itself when an exception can be made to the ban on end-of-life assistance. Art. 2 ECtHR also applies: ‘The right to life does not include the right to die. The state cannot therefore be obliged to provide assistance in suicide to another person’.
The Netherlands
The unusual thing in the Netherlands is that suicide is not a criminal offense, but assistance is. In 1886, this assistance was made punishable as an offense that in itself constitutes a crime. The Explanatory Memorandum states that the violation of respect for human life will be punished, regardless of the perpetrator’s motive. It is a ‘specialization of the general respect for human life’. Despite social changes, this is maintained in the Criminal Code:
Art 293. 1.: ‘He who deliberately ends the life of another at his express and serious desire shall be punished, etc.’ The basic principle is that termination of life without request is criminally murder. Art 293. 2.: ‘The doctor is not punishable under certain conditions’. Art 294. 2.: ‘Anyone who intentionally assists another in suicide or provides him with the means to do so will, if suicide follows, be punished, etc.’ The Dutch Supreme Court ruled in 2005 that offering moral support is not punishable.
In politics the prevailing idea is that we have achieved a good euthanasia practice with the euthanasia law. But there is no self-determination, euthanasia is just a favor from the doctor. The majority of Dutch people want to take matters into their own hands. This also includes the fact that they can call on help: from loved ones or from professionals, whatever they need.
Germany
In February 2020, the Constitutional Court in Karlsruhe struck down the ban on assisted suicide, making Germany a leader in assisted dying overnight. “Following the ruling of the German Supreme Court, the most important issue is how the right to own control over the end of life can be achieved. How many obstacles should be placed for those who want to decide for themselves about their own end of life? “. Two members of the Bundestag want to submit a liberal bill. At the same time, a total of 27 petitions have been submitted to the Bundestag, including one from three retired Protestant theologians. They demand the provision of Pentobarbital on demand. This demand was partly inspired by a television film adaptation of the play Gott. After the film screening there was an online discussion and a vote. It showed that 70% of viewers were in favor of providing a last-will drug to a healthy person who wanted to end his life. However, in November 2023, the Administrative Court in Liepzig rejected the claim for the free provision of an euthanatic.
A similar process is underway in Austria. On December 11, 2020, the Austrian Supreme Court ruled that the current ban on assisted suicide is unconstitutional and will be declared invalid at the end of 2021. ‘The right to free self-determination includes the right to direct one’s own life as well as the right to die with dignity ‘, the judges stated. “This also means that someone who wants to end their life can call on someone for help, regardless of who that is.”
In Switzerland there has been room for assisted suicide for some time now. This help may be provided by doctors, but also by others. The only requirements set by Swiss law are that the care provider does not do this for selfish reasons and that the person concerned is mentally competent. The room that is created is used by six organizations, including Dignitas and Pegasus. In principle, it is possible to end your life for around ten thousand euros (including the costs of cremation). Apart from the article in the Swiss criminal code that allows assisted suicide, nothing is regulated by law. Efforts have been made for ten years to specify the nature of the assistance, but the various doctors’ organizations cannot agree among themselves. And to the extent that regulations are clear, there is little interest in monitoring or testing. For example, there is a lot of room in Switzerland, but there are also risks for those who seek that room.
United Kingdom
In the UK the laws about euthanasia and assisted suicide are very conservative, to say the least. Both euthanasia and assisted suicide are illegal in the UK and could be prosecuted as murder or manslaughter. Although it is an offence to actively end a patient’s life, many doctors still assist their patients with their wishes by withholding treatment and reducing pain. This, however, is only done when the doctors feel that death is a few days away and after consulting patients, relatives or other doctors. So there is no self-determination whatsoever. Within the law the doctor decides about the moment of your dying and this condemns the patient to a long agony.
In England and Wales, people may make an advanced decision or appoint a proxy under the Mental Capacity Act 2005. By effect of this law, the Advance Decision to Refuse Treatment (ADRT) acquired statutory force among doctors, patients and their families. This is for an advanced refusal of life-saving treatment for when the person lacks mental capacity and must be considered to be valid and applicable by the medical staff concerned.
Unfortunately a lot of people in the UK are therefore dying horribly.
Conclusion
The Netherlands is no longer the guide country it used to be (or pretended to be). In Europe the countries that set the tone nowadays are Germany, Austria and Switzerland.