Tuesday, June 28, 2016

Euthanasia and assisted suicide in the Netherlands Belgium and Oregon - a comparative analysis.

Alex Schadenberg
International Chair - Euthanasia Prevention Coalition

An article written by Eveline Dokter and published by ntvg.nl news on June 20, 2016 compares the euthanasia and assisted suicide statistics in the Netherlands, Belgium and Oregon. The analysis by Dokter of the Netherlands euthanasia data is more indepth than the Belgian and Oregon data. Dokter reports in her article:
Since the introduction of the Dutch euthanasia law in 2002, the number of notifications for euthanasia nearly tripled. In 2015 doctors in the Netherlands reported 5516 cases of euthanasia or assisted suicide.(1) One of these reports came from the BES islands. In 109 patients dementia formed the basis of the suffering and in 56 patients a psychiatric disorder. Although the reporting rate for euthanasia over the years greatly increased, there is still underreporting. In 1990, doctors reported only 18% of the number of cases, in 2001, 54% and in 2010. 77%. (2) This means that still 914 cases of euthanasia were not reported in 2010.

The analysis by Doktor of the Belgian and Oregon laws is less indepth. For instance she doesn't report on the underreporting of euthanasia in Belgium. The article reports:
In Belgium and the US state of Oregon (assisted suicide) euthanasia is also allowed. In Oregon assisted suicide is allowed in patients with a short life expectancy. People who are not sick but who see their lives as completed are not eligible. Over the years in Oregon, Belgium and the Netherlands until 2014, both the absolute and relative numbers of euthanasia and assisted suicide have increased.(3-8) In 2015, doctors reported 4, 18 and 37 out of 1,000 deaths as euthanasia or assisted suicide. These figures are consistent with the trend previously up to 2012 reported in The Lancet.(9) It is striking that the vast majority of the Belgian euthanasia cases occurred in Flanders. This is probably due to the cultural differences between the Flemish and the Wallonians.(10)
Doktor didn't examine the New England Journal of Medicine (NEJM) published a study on March 19, 2015 showing that 4.6% of all deaths in Flanders (2013) are euthanasia, even though the official data indicates that 2.4% of the deaths are reported as euthanasia indicating that nearly half of all Belgian euthanasia deaths are not reported.

According to the 2015 Oregon death with dignity data summary, of 218 people who received a lethal prescription, the ingestion status was unknown for 43 of the people and 5 of the people who died, no report was submitted, meaning these are possible cases of underreporting.

Dokter provided the following references:
1. Regional assesment committee on euthanasia. 2015, April 2016. Jaarverslag (Yearly report).
3. Yearly reports Death with Dignity Act Oregon, via Public Health Oregon.
4. Death statistics Oregon, via Public Health Oregon.
5. Year reports euthanasia Belgium 2002-2015 http://leif.be/professionele-info/rapporten/.
6. Death statistics Belgium 2000-2015, Statbel mortalité generale.
7. Regional assessment committee euthanasia, Jaarverslag 2002-2015 (Yearly reports).
8. Death statistics the Netherlands 2000-2015, Statline CBS.
9. Claudia Gamondi et al. Legalisation of assisted suicide: a safeguard to euthanasia? The Lancet, vol 384, 12 juli 2014.

The translation was by Dr J.A. Raymakers

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