Last week, the Netherlands moved a step closer to legalizing
euthanasia, a practice it has tolerated for decades. The bill passed
the lower house of the Dutch parliament 104-40. It is expected to pass
the upper chamber early next year. However, this is considered a mere
formality. In 1993, parliament approved guidelines under which it was
understood that doctors would not be prosecuted for physician assisted
suicide, even though it remained a crime.
Not surprisingly, Dutch doctors, who are employees of the government,
have become cavalier about the practice. In 1997, when Wesley J. Smith
interviewed Dr. Pieter Admiraal, a Dutch euthanasia pioneer, for his
book “Forced Exit,” he claimed that 84 percent of Dutch doctors would
euthanize patients while only 16 percent would not.
Under the new Netherlands’ measure, a doctor would be allowed to
perform an assisted suicide if convinced the patient’s request was well
considered, if the patient’s suffering was “unbearable” and if the
doctor consulted with another independent physician who also examines
In practice it will not work that way. It isn’t working that way
now. In 1990, the Dutch government launched a study to see how
euthanasia was being carried out in the country. A year later, it
issued the Remmelink Report, named after Professor J. Remmelink, then
attorney general of the Dutch Supreme Court. Although it narrowed the
definition of euthanasia considerably, what it found wasn’t pretty. In
1990, of the approximately 90,000 people who did not die suddenly, 11.1
percent were euthanized and more than half of these killings were
involuntary. Fourteen percent of those involuntarily euthanized were
fully competent to make their own medical decisions.
Many of these cases do not involve people who are suffering or even
ill. The Nov. 11 Lancet reported the death of an 86-year-old man in
good health who was euthanized because he said he had no friends or
family left and “found life unbearable.”
However, many of the so-called voluntary cases clearly involve
coercion, like the case of a man who became too ill to care for himself.
His wife gave him a choice of being euthanized at home or going to a
nursing home. In those nursing homes, the elderly are afraid to drink
their orange juice for fear of being poisoned. Those with incurable
diseases are afraid to go to hospitals to have their distresses
The very young fare no better. Children who have birth defects, or
somehow fail to measure up, are left to die of neglect in their cribs.
If they fail to expire in a timely fashion, they are killed.
Medical schools in Holland have stopped training doctors to treat
people with chronic pain and hospice care has all but disappeared.
There was the celebrated case of a Catholic nun who was euthanized
without her consent because she was dying of cancer, and her physician
decided her pain was too much to bear and that she would not consent to
death because of her religious convictions.
When you examine Holland’s socialist-style of government, the push
for euthanasia is not surprising. In a country where individuals are
guaranteed a certain standard of living by their government, the cost is
enormous. There is a free enterprise system, but it is heavily burdened
to pay for this cradle to grave care. The top tax rate is 60 percent,
but there are yearly “wealth” taxes that are levied on the assets of
Dutch citizens. The effective tax rate on the upper middle class is 70
to 80 percent. The effective tax rate on the upper class, which has
all but disappeared, is 80 to 90 percent. Dutch doctors receive modest
middle class salaries from the Dutch government. There is pressure from
every side to keep the cost of medical treatment down. As a result, it
is coming down to a system of survival of the fittest.
Taxes consume 47 percent of the Netherlands’ Gross Domestic Product.
In contrast, taxes here in the United States consume 35 percent of GDP.
However, you must remember that the lion’s share of the tax burden rests
on the top one-quarter of our population, those with combined family
incomes of $48,000 and above.
If the growth in government spending remains as it is now, and
nothing is done to reform Medicare and Social Security, the tax burden
on our children and grandchildren will be enormous. In 1994, the
lifetime effective tax rate, estimated by the Office of Management and
Budget for generations born that year and thereafter, is expected to be
a whopping 85 percent. This figure was so depressing that President
Clinton, who continued to push for bigger government and more spending,
ended this annual study the following year.
The pressure on our elected representatives in Washington is to
spend, spend and spend. The chief of staff of one of the most frugal
members of the U.S. House of Representatives lamented to me, “No one
ever calls our office and says, ‘Don’t spend!’” As a result, in the
2001 budget, domestic discretionary spending has ballooned to $650
billion. This week, when the lame duck session of Congress goes back to
work on the budget, domestic discretionary spending is expected to rise
another $20 billion. That’s $130 billion more than the caps both
parties agreed to in 1997.
Both presidential candidates, Al Gore and George W. Bush, have called
for even more spending, although Gore’s plan is by far the most
One of the darkest days in the administration of President George H.
W. Bush was the day the Patient Self-Determination Act was sneaked into
his 1990 Budget Accord. This compromise with the Democrats was called a
“500 Billion Deficit Reduction Package,” but actually was designed to
increase spending, raise taxes and raise the level of our national debt
another $527 billion. It not only proved to be President Bush’s
undoing, it put the federal government in the business of promoting the
agenda of the euthanasia movement.
The new PSDA law required hospitals, nursing homes and other
care-providing agencies to inform patients entering these facilities of
their right to refuse life-sustaining health care. Although not
required, hospitals, under pressure from the federal government to
control the cost of Medicare and Medicaid began offering their patients
advance directives. Sometimes called living wills, these advanced
directives, more often than not, have elastic, inexact language designed
to grant immunity to health care providers for withholding readily
Patients generally are sick or under a great deal of stress as they
enter hospitals. They are ill equipped to deal with the large number of
forms thrust upon them at that time. Most simply sign all of them
without question, often with tragic results:
- In the Midwest, the 73-year-old mother of Phyllis J. Robb
entered the hospital for a hip replacement. According to her daughter,
she was in excellent health and on the road to recovery when she
suffered cardiac arrest due to an embolism, but was not assisted because
she had signed a standard living will while she was in transitional
care. According to hospital records, it took some 20 minutes for her to
- In Washington State, Mary Jo Estep, a nursing home resident who
was getting ready to go to a birthday party, accidentally was given
medication intended for another patient which proved fatal to her. The
mistake was discovered before she died, but she wasn’t told about the
mistake or given the option of seeking emergency treatment because she
was considered a non-code patient after signing a form which said
cardiac pulmonary resuscitation should not be initiated. The form did
not address her current medical situation.
When admitting patients are presented these advance directives
they never are told that these documents do not give them any new
rights, but may limit their right to life-sustaining treatment. Nor are
they told it is not necessary to sign them in order to be admitted.
When euthanasia officially is legalized in the Netherlands, other
countries may be poised to follow suit. Legislators in France and
Belgium have been debating the issue where taxes now consume 52 percent
and 50 percent of GDP respectively.
With the closest presidential election in our history and a
legislature almost evenly divided, there is talk of compromise, which
means bigger government, more socialist programs and more spending.
This could lead us further down the road of limiting health care to one
that actively promotes euthanasia. Many believe we already are there.
Oregon has legalized assisted suicide. In Alaska, euthanasia advocates
are challenging a statute prohibiting assisted suicide, and, in
California, legislators are looking at bringing up a second assisted
History has shown that when citizens are guaranteed the necessities
of food, shelter and health care, whether or not they contribute to
society, government ultimately cannot keep up with the demand and those
who are young, old, sick or infirm become vulnerable.
Know your rights: Contact the International Anti-Euthanasia Task
Force at P.O. Box 760, Steubenville, OH 43952, 740-282-3810,
www.IAETF.org to obtain a Protective Medical Decisions Document for