Does Dutch Euthanasia for Patients with Dementia Expose a Threat to U.S. Patients?

Jennifer Popik, J.D. Robert Powell Center for Medical Ethics

By Jennifer Popik, JD, Robert Powell Center for Medical Ethics

  Reports coming out of the Netherlands add to mounting evidence that physician-assisted suicide, over time, leads to the nonvoluntary euthanizing of patients—patients who neither requested nor authorized their deaths. (;

In a recent article appearing in the British publication the Daily Mail, there was a well documented case where the once highly touted “safeguard”–that only competent people currently asking for death will be killed–was willfully abandoned.  A 64-year-old woman with severe dementia who was euthanized in the Netherlands–even though she was no longer competent. 

The article [] reported,

“The unnamed woman was a long-term supporter of the controversial practice and had made a written statement when she was still well, saying how she wished to die.  But the pensioner, who died in March, had been unable to reiterate her instructions as the disease progressed, Volkskrant reported.”

The Daily Mail reported that this practice of killing patients with dementia is on the rise, and is being documented.  “A report released earlier this year revealed a total of 21 patients with early-stage dementia, including Alzheimer’s died by lethal injection in Holland in 2010. This is the first time dementia sufferers have been included in the country’s euthanasia statistics.”

    Even so, does this pose a threat to those in the United States? After all, assisting suicide is currently legal in only two states–-Oregon and Washington–and may have some legal basis in the state of Montana, due to a 2010 court decision. 

    However while assisting suicide remains illegal in nearly every jurisdiction in the United States, those who tirelessly promote doctor-prescribed death are on the offensive in New England. 

   There is a current effort under way in Massachusetts to obtain 70,000 signatures of registered voters before a petition to legalize it can be presented to the legislature. If they get this far, lawmakers could either adopt it as a law or let voters decide send it to a referendum vote in the November 2012 general election.

   The other major effort is in Vermont.  Thanks to an outpouring of opposition, a bill to legalize doctor-prescribed death was not taken up in 2011, but could gain traction once the 2012 legislative session begins. 

   So what could happen next if two New England states were to join Oregon and Washington State? The more states that adopt these dangerous laws, the greater is the risk of other states  removing protection from vulnerable populations. 

Most would be shocked to learn that in the U.S., legalizing assisting suicide can legally mean legalizing nonvoluntary euthanasia.  While Compassion and Choices, the group promoting assisted suicide laws in the states, claims to only seek to allow doctor-prescribed death for the competent, such a limitation is often legally impossible.


But state courts have ruled time and again that if competent people have a right, the Equal Protection Clause of the United States Constitution’s Fourteenth Amendment requires that incompetent people be “given” the same “right.”


And it should be noted that in the Netherlands, legalizing voluntary assisted suicide for those with terminal illness has spread to include nonvoluntaryeuthanasia for many who have no terminal illnesses.  A 2009 article from the Daily Mail documented that, “Cases of [Dutch] euthanasia in the country have increased from 1,626 in 2003 to 2,331 in 2008.


It is also alleged that there have been thousands of cases of involuntary euthanasia and dozens of killings of disabled newborns.” [].This has meant that the problems for which death in now the legal “solution” include such things as mental illness, permanent disability, and even simple old age.



This cautionary tale being told in the Netherlands adds to mounting evidence that once human beings are regarded as disposable in some, initially carefully circumscribed circumstances, those circumstances will steadily expand.  “When you put a price on human life, the price goes down.” The threat of this happening in the United States might not be as far off as one might think.

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