Britain must learn from the Netherlands experience with assisted dying.

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

Theo Boer

Professor Theo Boer, who was member of a Netherlands Regional Euthanasia Review Committee for 9 years wrote an article that was published in the Spectator (UK) on February 26. Boer is a respected critic of the Netherlands euthanasia law and has closely followed the developments in the Netherlands for many years. Boer writes:

As a former member of a euthanasia review board in the Netherlands, I have closely followed the debate surrounding Kim Leadbeater’s assisted suicide bill. In 2001, and with 15 years of experience with makeshift regulations behind us, the Netherlands became the first country to introduce a euthanasia law. In support of this law, I worked from 2005 to 2014 for the authorities in charge of monitoring euthanasia cases. I was convinced that the Dutch had found the right balance between compassion, respect for human life, and guaranteeing individual freedoms.

However, over the past two and a half decades, I have become increasingly concerned as I have witnessed the steady expansion of the euthanasia system and its eligibility criteria. A system designed to apply to comparatively rare cases was, by 2023, accounting for 5.4 per cent of all deaths in the Netherlands, with the numbers continuing to rise. In one region, euthanasia even accounts for up to one in every six deaths. Euthanasia in the Netherlands is now available to children, and indeed infants, of all ages, and there are continuing attempts to extend it to anyone over 74 who considers their life ‘complete’. In May 2023, a Kingston University study found that there were 39 cases of euthanasia in the country for people with learning disabilities, autism, or both between 2012 and 2021. We have also had our fair share of contested stories, including a well-known case in 2018 involving a woman with dementia being euthanised apparently against her will, as family members insisted that her advance directive should trump her present expressions.

Boer explains that the British assisted suicide debate is similar to the debate that occurred in the Netherlands.

Much about the debate in the UK reminds me of our experience in the Netherlands, including Leadbeater’s insistence that the rules will be strict. Our safeguards were presented that way too. Euthanasia campaigners assured us that it would only apply to a well-defined group of patients. It is through bitter experience, through being on the front-line here in the Netherlands for almost two decades, that I have concluded that it is not possible to regulate and restrict assisted dying safely in the way its advocates claim. Once the first step is taken, euthanasia advocates invoke the principle of equality: why is assisted death only for terminal patients, as chronically ill patients may suffer all the more? Why only for sick physically patients, given the absolute horrors of psychiatric suffering? Why not include people with non-medical causes of suffering, such as grief? And once we allow euthanasia for competent patients, why withhold this blessing from the incompetent?

I know that right now leading campaigners for assisted suicide laws in the UK are asking people to believe that somehow the UK will be the exception, that the safeguards will be unique and enduring. My message to my British friends would be to be incredibly cautious about letting such aspirations triumph over the hard-trodden experience of so many other jurisdictions that have introduced such laws.

Boer is concerned with the UK parliament assisted suicide debate.

I followed some of the parliamentary proceedings late last month where a committee of MPs took evidence from various experts about the bill. I was surprised that all eight of the invited international witnesses are on record as being in favour of assisted dying. The large majority of these experts were Australians, a country not even close to the Netherlands and Belgium in terms of years of experience. Leadbeater should have included witnesses from jurisdictions where assisted dying has been legal for a much longer time, and where things have not worked out as originally promised.

Boer comments on the proposed changes to the UK assisted suicide bill.

Extraordinarily, every single amendment relating to Clause 1 of the Bill, which aimed to strengthen the proposed safeguards, was rejected. Ahead of second reading, I recall Leadbeater trumpeting her ‘High Court safeguard’, which she said made her legislation the strictest in the world. Leadbeater has now said she is going to drop this safeguard and replace it with panels of experts, likely resulting in them being made up of supporters of assisted dying, as those who do not support the practice would not wish to be involved. The bill is being weakened, not strengthened.

I am also concerned that one MP on the committee has already tried replacing the six-month terminal diagnosis requirement with a 12-month one for certain conditions. Any physician knows how hard it is to make predictions about a six-month life expectancy, and adding a 12-month condition for some illnesses will make the life-expectancy criterion an empty formality. Britain is on a slippery slope. This is exactly what happened in the Benelux countries and in Canada. 

Some previous articles by Theo Boer:

• British proposed assisted death criteria are similar to how Canada's law began (Link). 
• Euthanasia: Impossible to police once legal (Link). 
• Let's not romanticize the Dutch euthanasia experiment (Link). 
• Be careful what you wish for when you legalize active killing (Link).