· The attending physician must be convinced that the request of the patient to end his life is of his own free will and well thought out.
· The suffering of the patient is unbearable and without chances for relief.
· The physician has fully informed the patient of his situation and the prospects.
· The physician and the patient together reached the conclusion that there is no other reasonable solution
· The physician has consulted with at least one other, independent physician, who has examined the patient and given a written opinion about the situation, based on the demands for thoroughness
· The physician has conducted the euthanasia in a medically careful manner
The physician is obliged to report the performance of euthanasia to the authorities and a special oversight committee monitors all cases. This committee consist of at least a physician, a jurist and an ethicist.
The issue of euthanasia is being struggled with in several countries and Holland is not the only country today that allows euthanasia and assistance with dying.
However, it is remarkable that with the regulation in the Netherlands as described in short above, the patient is placed in the center. Not his family, not his religion, not the ethical ideas of others, only the patient. If the patient is enduring unbearable suffering (and this may include in special cases also mental suffering), if the patient decides that he does not want to live anymore, in Holland he has the right to make decisions about his own life, including ending it.
The main obstacle that legislation on euthanasia has to overcome almost everywhere is religion. In most European countries, the opposition to euthanasia is based on religious ethic. Christian literature, both Old and New Testament, contain numerous passages emphasizing that God alone gives life and God alone can take life. The same passages have been used to condemn birth control and abortion successfully over the years and especially the Catholic Church has been very strongly opposed to birth control, abortion and euthanasia.
In Israel, euthanasia is forbidden by law. A couple of years ago, the Israeli Dying Patient Act was legislated which was designed to “Strike a Balance between maximizing patient Autonomy in End of Life decisions, while still being consistent with the dictates of religious practice”. In other words, the patient does not have full control over his life (and his death) and religious aspects have to be taken into account (whether the patient believes in these religious aspects or not).
Anybody who has had to deal with a terminally ill relative or friend is aware that the result of these limitations is a form of Assisted Suicide performed by physicians in Israeli hospitals simply by increasing the dosage of painkillers and/or sedatives to a level that will allow the patient to sink into oblivion. Moreover, the legal situation of this is probably unclear since the Israeli Dying Patient Act states: “Patients have the right to receive maximal pharmacologic analgesia even when treatment may shorten life”. Interpreted broadly, this is in fact euthanasia but camouflaged carefully to, apparently, appease religious circles.
In Israel, religion increasingly exerts influence on public and private lives of its citizens. But shouldn’t death be a personal matter? Euthanasia will not (I would hope) become obligatory, and anybody who feels or believes that for religious or other reasons he cannot make a decision to end his own life is free to await the end as and when it comes. However, the right to die is not as strong as the right to life apparently and will not be as long as religion is allowed to exert control over those who are interested in that control as well as over those who are not.
May you “Live Long and Prosper.”