Should mental illness be considered grounds for allowing medical doctors to end the lives of patients?
Since the "Termination of Life on Request and Assisted Suicide (Review Procedures)" Act first took effect in the Netherlands in 2002, thousands of cases of physician-assisted suicide have occurred, whether involving patients taking an active role in their own deaths or doctors administering fatal doses for patients unable to take the drug themselves. Under Dutch law, euthanasia is permitted for any adult having an incurable illness with no chance of improvement so long as the euthanasia decision is independently reviewed by a second physician. Patients between the age of twelve and sixteen are also allowed to request euthanasia with parental permission.
While the overwhelming majority of cases of legal euthanasia are patients suffering from cancer or other physical illnesses, the question of whether patients suffering from psychiatric illness should be allowed to end their own lives has become controversial. While typically reserved for patients reporting "unbearable and hopeless suffering" and who are mentally capable of choosing to end their lives, there have been an increasing number of cases of psychiatric patients being granted permission as well.
In 2012, the Life Ending Clinic first opened in The Hague to provide euthanasia services for patients whose personal physicians refused to permit suicide. Many of the patients coming to the clinic are suffering from non-terminal illnesses such as the early stages of dementia, chronic depression, and other psychiatric illnesses. In 2013 alone, 749 patients came to the Life-Ending Clinic with a euthanasia request with 133 being granted. According to the statistics released by the clinic, the number of euthanasia cases relating to dementia are 18 times the national average. Euthanasia cases involving psychiatric patients are five times the national average. In a press release, the clinic acknowledged the "figures over 2013 show a strong growth of euthanasia in these groups."
This rise in euthanasia cases has drawn fire from right-to-life groups in the Netherlands and even Republican politicians in the United States attempting to draw parallels between Dutch euthanasia and the Affordable Care Act. In 2012, Republican Presidential candidate Rick Santorum used the Netherland case as part of his accusation that Obamacare fostered "death panels" by stating that Dutch elders lived in fear of being euthanised involuntarily. He also stated that half of all euthanasia cases are involuntary - a statistic that has since been disproven.
In the Netherlands, one of the early pioneers of the euthanasia movement, psychiatrist Boudewijn Chabot, has become increasingly critical of how the euthanasia legislation is being applied. Convicted in 1991 for assisting in a patient's death, Chabot now feels that the euthanasia legislation he helped promote has "gone off the rails."
In an interview with a Dutch news program, Chabot noted that many Dutch have made living wills to declare their feelings about euthanasia even if they were no longer capable of making their own decisions. Despite the popularity of these wills, Chabot suggests that circumstances may change which may make them invalid for “a seriously demented person who no longer knows what it means.”