Assisted suicide rates changed little since Dutch legalization

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Doctors have been allowed to help patients end their lives in the Netherlands for a decade by giving them lethal drugs, a practice that has sometimes stoked alarm outside the country, even popping up in American political debate this year.

Now a new study says little has changed since the Dutch law was enacted. Euthanasia and assisted suicide are roughly as common in the Netherlands as they were before the law went into effect, according to research published Wednesday in the journal Lancet.

Researchers quizzed Dutch doctors about the practice of supplying lethal drugs in confidential questionnaires, a method believed to get more accurate results than the official numbers reported to the state.

Doctors are supposed to report euthanasia and assisted suicide to a government commission that reviews cases and punishes doctors if they do not follow rules restricting who can be assisted to die. Under the Dutch law, the patient must explicitly request to end his or her life, have unbearable suffering, and meet other requirements before a doctor can administer lethal drugs or let the patient take them.

The study found that in 2010, 2.8% of deaths in the Netherlands were the result of euthanasia, a higher rate than that seen in 2005 but similar to euthanasia rates in 2001 and 1995, before the law went into effect. Assisted suicide rates stayed stable at 0.1%. (Assisted suicide differs from euthanasia under Dutch law in that the patient, not the doctor, administers the prescribed lethal drugs.)

The most disputed practice -- ending life without an explicit patient request -- occurred in only 13 out of nearly 7,000 cases reviewed in 2010, the researchers found. The numbers counter claims by former U.S. Republican presidential candidate Rick Santorum, who said this year that “forced euthanasia” made up 5% of deaths in the Netherlands, a statement quickly refuted by Dutch officials.

Though the practice of ending life without an explicit patient request is apparently rare and has declined, doing so is still against Dutch law and “ethically problematic,” medical ethicist Bernard Lo wrote in a commentary on the new study.

The study was funded by the Netherlands Organization for Research and Development and conducted by a team of Dutch researchers. The country is one of just a few where assisted suicide or euthanasia are legal, making it a closely watched example for other nations where the practice is under debate.

“Although translating these results to other countries is not straightforward, they can inform the debate on legalization of euthanasia or physician-assisted suicide in other countries,” the researchers wrote.

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-- Emily Alpert in Los Angeles