SAVES is not affiliated with Exit International / Dr Philip Nitschke and opposes the public availability of a 'peaceful pill'.

The Journal of Medical Ethics published an article by two staunch opponents of voluntary euthanasia in February this year (1). Their article reported on the interpretation of a 1996 survey of euthanasia in the Netherlands and concluded that although there had been improvement in compliance with procedural requirements, the practice of voluntary euthanasia in that country remained beyond effective control.

The media interpreted this as "out of control", tending to ignore the balanced editorial on the topic and two other papers in the same issue (2,3,4). Defects in the practice of voluntary euthanasia in the Netherlands (and elsewhere) are not in dispute but a substantial majority of the Dutch people want access to voluntary euthanasia and its legalisation is now a part of government policy. No evidence likely to persuade Dutch authorities to reverse their approach is available.

The reports are quite detailed and warrant careful study. They represent part of the process of improving legislation governing end-of-life medical care in democratic cultures. For the moment voluntary euthanasia is prohibited beyond the Netherlands but widely practiced. The crucial question is whether the defects in its practice are worse under prohibition.

This question was answered for Australia by a study reported in the Medical Journal of Australia in 1997 (5). The results of this study, summarised in SAVES Fact Sheet 21, showed that the situation in Australia is clearly less satisfactory than in the Netherlands. Not surprisingly, the Australian study has been attacked by opponents of legalising voluntary euthanasia as being flawed in various ways and these attacks vigorously defended, again part of the process referred to above.

As van Delden states (3) "But the interpretation of these facts (from the studies) remains largely dependent upon our moral views." Thus those who believe our future lies in responsible personal autonomy, ie, the right to choose, will seek to remove the defects rather than conclude that the right to choose is beyond our grasp.

References

1. Jochemsen H, Keown J. Voluntary euthanasia under control? Further empirical evidence from the Netherlands. J Med Ethics 1999;25:16-21.
2. Gillon, R. Euthanasia in the Netherlands - Down the slippery slope? J Med Ethics 1999;25:3-4.
3. Delden JJM van. Slippery slopes in flat countries - a response. J Med Ethics 1999;25:22-24.
4. Cuperus-Bosma JM et al. Assessment of physician-assisted death by members of the public prosecution ... J Med Ethics 1999;25:8-15.
5. Kuhse H, Singer P, Baume P et al. End-of-life decisions in Australian medical practice. Med J Aust. 1997;166:191-6.