Netherlands: 22% of the assisted deaths were not reported in 2021.
Executive Director,
Euthanasia Prevention Coalition
The Netherlands has had a problem with euthanasia without request (LAWER) and the under-reporting of euthanasia since the inception of its euthanasia law.
Every five years the Netherlands government has commissioned a study to determine the number of deaths by medical and end-of-life decisions. The study is done by researchers who send questionnaires to physicians to determine how a random person died within a given year.
The questions seek to determine the number of deaths from all causes, including euthanasia, assisted suicide and ending of life without explicit request. The questionnaires allow the physician to respond anonymously, the data effectively uncovers the actual number of assisted deaths within a given year.
The Netherlands 2021 study (one year later than usual) found that there were 9,799 assisted deaths representing 9038 euthanasia deaths, 245 assisted suicide deaths and 517 ending of life without explicit request (LAWER).
LAWER involves the intentional ending of a person without an explicit request. I oppose euthanasia and assisted suicide but I recognize that killing someone without request or consent remains a criminal homicide in nearly every jurisdictions, even when it is tolerated.
The 2021 study indicated that there were 517 LAWER deaths in the Netherlands representing approximately 0.3% of all deaths.
It is important to note that 6 of the deaths were newborns, also known as infanticide who would have been killed based on the Groningen protocol. Newborns with disabilities can be injected with lethal drugs in the Netherlands when a parent and doctor agree that the prospects for the child are poor or the child is considered "incompatible with life."
As stated, the Netherlands government commissions a study every five years. The 2015 study was published in the New England Journal of Medicine (NEJM) in an article titled: End-of-Life Decisions in the Netherlands over 25 years. The researchers published the 2015 study as a comparison to the previous studies.
The
data from the 2015 study indicated that there were 7254 assisted deaths
representing 6672 euthanasia deaths, 150 assisted suicide deaths, 431
ending of life without explicit request.
The 517 LAWER deaths in 2021 and the 431 LAWER deaths in 2015 represent a similar percentage of all deaths in the Netherlands meaning that doctors in the Netherlands continue, at a similar rate, to kill people without an explicit request or consent.
Do physicians in other countries, including Canada intentionally kill people without an explicit request or consent. The answer is likely YES, but unlike the Netherlands and Belgium, other countries are not commissioning studies with specific questions to uncover the truth.
The issue of under-reporting of euthanasia in the Netherlands.
The Netherlands 2021 euthanasia report stated that the number of reported euthanasia deaths in the Netherlands was to 7666. The report also indicated that there were 206 reported euthanasia deaths for early stage dementia and 6 reported euthanasia deaths for late stage dementia and 115 reported euthanasia deaths for "severe" mental illness.
The data from the 2021 Netherlands government study found that there were 9,799 assisted deaths but the data from the Netherlands 2021 euthanasia report indicated that there were 7666 assisted deaths. Therefore (9,799 - 7,666) there were 2133 unreported assisted deaths in the Netherlands in 2021 representing approximately 22% of all assisted deaths.
Has under-reporting of euthanasia been a consistent problem in the Netherlands?
The 2015 study was published in the New England Journal of Medicine End-of-Life Decisions in the Netherlands over 25 years indicated that there were 7254 assisted deaths in 2015.
The Netherlands 2015 official euthanasia report stated that there were 5561 reported assisted deaths but the data from the 2015 Netherlands government study indicated that there were 7254 assisted deaths meaning that there were 1693 unreported assisted deaths in 2015 representing about 23% of all assisted deaths in 2015.
When examining the data from previous Netherlands studies, it appears that more than 20% of all assisted deaths are consistently not reported.
Does Canada have a similar problem with under-reporting?
Canada legalized euthanasia (MAiD) in 2016. The Canadian government has not commissioned a death study to determine if abuse of the law occurs. The Québec euthanasia data indicates that there is under-reporting of euthanasia.
Amy Hasbrouck, the past president of the Euthanasia Prevention Coalition and the leader of Toujours-Vivant (Not Dead Yet) analyzed the Quebec 2021-22 euthanasia report and found a discrepancy of 289 euthanasia deaths. Hasbrouck reported:
The Commission reported 3,663 euthanasia deaths declared by doctors during the fiscal year (p. 13), while the number of euthanasia deaths reported by facilities (3,629) and the Collège des Médecins du Québec (323) totalled 3,952 (p. 25 at note 25); a discrepancy of 289 deaths.
Hasbrouck found in the 2021 - 22 Québec annual euthanasia report a 7% likely under-reporting rate. Under-reporting of euthanasia may be occurring in the rest of Canada, but it is impossible to determine what is actually happening unless the Canadian government commissions a similar study to the Netherlands 5 year studies.
American assisted suicide laws.
There is evidence that under-reporting of assisted suicide is likely occurring in the US states that have legalized assisted suicide.
For instance, the 2024 Oregon assisted suicide report
indicated that there were 376 reported assisted suicide deaths in 2024.
(There were likely close to 400 reported assisted suicide deaths since
every year a percentage of the assisted suicide reports are received
late).
The 2024 Oregon assisted suicide report indicated that the
ingestion status is unknown in 178 cases. When the ingestion status is unknown, it means that the 178 people were approved for assisted suicide and received the lethal drugs but the Oregon Health Authority OHA does not know if they died by assisted suicide. Since no oversight exists and no research has
not been done to confirm how these people died therefore it is impossible to say with certainty that unreported assisted suicide deaths are happening, but it is likely.
My conclusions.
The Netherlands 2021 study indicates that euthanasia without explicit consent and unreported euthanasia deaths continue.
Exposing Vulnerable People concluded that - when an assisted death was done "outside of the
parameters of the law" that the death was rarely reported. It is likely that, if the researchers closely examined the 517
life-ending without request assisted deaths in 2021 they would likely find that
most of these deaths were not reported.
Exposing Vulnerable People also concluded that the majority of LAWER deaths were done in a hospital to an incompetent person who was unable to consent.
Without a data breakdown of the 2021 study data I cannot assume a similar conclusion but earlier data clearly indicated this reality.
I found it interesting that unlike the previous Netherlands government death studies (every 5 years), there was no analysis of the data which is why I am writing this article in 2025.
The 2021 Netherlands study proves that euthanasia deaths without explicit request or consent continues to happen and that more than 20% of the Netherlands euthanasia deaths continue to be not reported.
The data from the study should also ask the question, is there a similar phenomenon of killing patients without explicit request or consent happening in Canada or other countries and it should ask how many unreported euthanasia deaths happen in Canada and other countries? A study needs to be commissioned by neutral researchers to determine the answers to these questions.
Legalizing euthanasia and assisted suicide does not eliminate the phenomenon of medical homicide and the normalization of euthanasia seems to justify these acts.
3 comments:
I think that the unreported and often non-consensual deaths you have exposed might be thought of as "peripheral" assisted dying.
Going all the way back to 1993 there were obviously illegal assisted suicides performed in Canada, since Sue Rodriguez herself died in this manner without anybody facing charges. Even at that time people praised Sue's "courage" in taking her case to the courts instead of simply using the clandestine network already functioning (it is proudly alleged to the tune of "hundreds" per year even at that time).
So we can conclude that there has always been a very significant "grey" zone in which active laws were not enforced. Furthermore, the legalization of euthanasia where death is "reasonably" foreseeable did not solve the Rodriguez problem, since she herself was not in that category. Obviously all kinds of non-terminal people died in this way, from 2014 (Quebec) until 2021, outside the parameters of law.
Similarly, since the law was changed to include viable patients, but while the authorization for mental illness alone was left in limbo, we can be absolutely sure that people have been killed for this reason as well.
Furthermore, the idea of killing incapable people clearly falls, also, within this peripheral zone, as it is ultimately essential to an ethical application of homicide defined as medical treatment. Quite simply: if we are ethically required to give incapable individuals insulin, when neccesary, then we are similarly ethically obliged to provide MAID for those eligible.
All of this is quite clear to those of us who have been following this subject. But it is also very disconcerting. For how could all of this be so studiously ignored in the public square while politicians were assuring us that only a handful of strictly regulated, fully voluntary deaths were contemplated?
Most of the people responsible for this are still alive. Perhaps we should have a ceremony of public reconciliation where they are put in stocks on the Parliament lawn wearing T-shirts saying "In 2014 I said there would likely be 300 per year" or "I promised Canadian's no one else's treatment would change in any way".
In any case, judging from the way that real (unreported and illegal) practice is evolving, and from the way that the law has been adjusted to keep up. We will have all the trouble in the world to stave off normalized euthanasia of the mentally ill and otherwise incompetent (and even incapable) patients.
After all, these things are already apparently taking place now in a protected "peripheral" zone surrounding actual legal practice.
When bad behaviors get normalized (such as cheating, lying or killing), it prefigures really bad things happening in the future. Things can only get worse.
-Thomas Lester
Psalms 12:8 The wicked prowl on every side,
When vileness is exalted among the sons of men.
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