Doctors in the Netherlands fear a legal test case has stretched the conditions under which euthanasia and assisted suicide may be practised. A court in Haarlem has accepted that an 86 year old man obsessed with his “physical decline” and “hopeless existence” was suffering “hopelessly and unbearably”—one of four criteria protecting doctors against prosecution.
Though he had no serious physical or psychiatric illness, his GP was acquitted after helping him to commit suicide. The public prosecution service had called for the GP to be given a three month suspended prison sentence. A spokesman for the Royal Dutch Medical Association, said the definition of “unbearable suffering” had been “stretched too far.” He said: “What is new is that it goes beyond physical or psychiatric illness to include social decline. We are concerned this judgment will marginalise the role of the GP.”
Edward Brongersma had first made a written euthanasia declaration in 1984. He had expressed his wish to Dr Philip Sutorius, his GP since 1986, on at least eight occasions. A month before his suicide in April 1998 he said that death had “forgotten” him, his friends and relatives were dead, and he experienced “a pointless and empty existence.” A second medical opinion confirmed that he was suffering hopelessly, and a psychiatrist said he had no treatable psychiatric illness.
The public prosecution accepted that Dr Sutorius is a conscientious GP, confronted with a difficult request, which he addressed with prudence and professionalism. The prosecution recognised that he fulfilled all the other legal criteria but denied there was “hopeless and unbearable suffering.” Mr Brongersma's request should therefore have been refused. Three medical experts asked to review the case concluded, however, that Mr Brongersma was suffering unbearably and there was no possible medical treatment.
Professor of medical ethics Inez de Beaufort of the public health department of Erasmus University, Rotterdam, recognised that no medical-ethical consensus exists. But he argued that such suffering could be characterised by the lack of prospects for improvement and general hopelessness. The court accepted “good medical-ethical arguments” that Mr Brongersma suffered “unbearably” and therefore Dr Sutorius made a justifiable choice between his obligations to maintain life and to relieve suffering. The Dutch medical association believes that more debate is required. Justice minister Benk Korthals has said that being “tired of life” is not sufficient reason for euthanasia. The public prosecutions office is to appeal to the High Court. MPs are divided, with governing coalition members supporting the judgment and those from the opposition Christian parties fearing it could allow euthanasia for anyone who is “ready to die.”