Op-Ed

Santorum more right than wrong about Dutch euthanasia

Wesley J. Smith Senior Fellow, The Discovery Institute
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The Dutch like their euthanasia — but sure are sensitive when a prominent person describes the horrors that medicalized killing has unleashed. Latest example: Republican presidential candidate Rick Santorum criticized Dutch euthanasia in an interview with James Dobson, stating in part:

Ten percent of all deaths, and half of those people are euthanized involuntarily, because they are old or sick. And so elderly people in the Netherlands don’t go into a hospital. They go to another country.

The Dutch media pounced, mocking Santorum for charging their doctors with “murdering” the elderly on “a grand scale.” Alas, he asked for it because he got the details wrong. When decrying the culture of death, one must be as accurate as possible. Otherwise, the fish wiggles off the hook.

But the media mocking had a purpose beyond making fun of a conservative. It distracted people from the fact that Santorum’s overarching message is true — euthanasia consciousness breaches the dikes of morality and exposes the weak and vulnerable to great risk. Indeed, while Santorum overstated some of the details — the elderly are not flocking to out-of-country hospitals — he was spot-on regarding the charge that many Dutch doctors practice death medicine. Indeed, anyone paying attention to recent stories from the Netherlands knows that things have gone from very bad to much, much worse.

Official Dutch euthanasia statistics undercount the actual toll: Much was made out of Santorum’s claim of a 10% euthanasia rate when official statistics generally report that 2-3% of Dutch deaths come from doctor-administered lethal injection. (The same rate in the USA would amount to about 70,000 euthanasia killings per year.) But realize, about 1/3 of the Dutch die suddenly, e.g. by sudden stroke, heart attack, or accident, without significant end-of-life medical intervention. Take those deaths away from the total count, and using the Dutch government’s estimate, the percentage of euthanasia deaths in cases involving end-of-life medical treatment rises to 3-4%.

But even that number is far too low. Repeated studies have shown that Dutch doctors fail to report at least 20% (or more) of actual euthanasia deaths, which means that hundreds of euthanasias aren’t included in the official statistical count. Moreover, about 1% of all Dutch deaths come as a result, to use Dutch parlance, of being “terminated without request or consent” — e.g. non-voluntary euthanasia. Such deaths are also not technically part of the official euthanasia count. That gets us up to about 6% of all deaths involving medical treatment at the time of death. Add in a few hundred assisted suicides each year where the patient takes the final death action rather than being lethally injected, and suddenly, Santorum’s 10% claim becomes far less problematic.

Wait, there’s more: Dutch doctors also kill patients by intentionally overdosing them with pain killers. I am not referring here to death caused as a side effect of legitimate pain control, but overdosing with the intent of causing death. The exact number of these deaths isn’t known, but the authoritative 1990 government study known as the Remmelink Report found that there were 8,100 deaths from intentional opioid overdose, of which 61% were done without the request or consent of patients. Now, add in, say, half of the nearly 10% of deaths that occur after Dutch doctors place patients into artificial comas and deny them food and water — that is, those cases in which palliative sedation is not medically necessary to control otherwise irremediable suffering — and we see that Santorum’s claim of a 10% euthanasia rate isn’t materially overstated at all.

The Dutch are moving toward euthanizing the elderly: A Dutch elderly dementia patient was recently euthanized in the Netherlands without request and despite being incompetent — and the killing received the approval of the state. Meanwhile, the Dutch parliament is actively debating whether to expand the practice of assisted suicide to the elderly “tired of life” or who want to die because they “consider their lives complete.” Not coincidentally, a Dutch Medical Association (KNMG) ethics opinion advocated including “loneliness,” loss of social skills and money problems among the factors for allowing the elderly to receive legal doctor-prescribed or doctor-administered death.

Dutch doctors teach patients how to commit suicide: The KNMG’s ethical report also gave physicians license to teach patients how to commit suicide:

There is no punishment for physicians and other persons if they provide information about suicide. Physicians are also legally permitted to refer patients to information that is available on the Internet or to publications sold by book vendors, or provide these on loan, and to discuss this information with patients.

Meanwhile, Dutch psychiatrists are about to assume a larger role in committing active euthanasia, including — according to the Dutch-language Journal of Psychiatry (Tijdschrift voor Psychiatrie) 53 (2011) 8 — for mental patients. Not that this is new. Twenty years ago the Dutch Supreme Court ruled that a psychiatrist who assisted the suicide of a grieving mother whose two children had died acted within proper euthanasia parameters.

I could go on and on:

● Dutch doctors have published the Groningen Protocol, a bureaucratic checklist for committing infanticide on terminally ill and seriously disabled babies, as two studies in The Lancet show that 8% of all babies who die in the Netherlands each year (about 90) are terminated by doctors.

● Mobile euthanasia “clinics” will soon be operating to bring euthanasia to the homes of patients whose own doctors say no.

● The Dutch media also mocked Santorum for claiming that thousands of Dutch citizens wear bracelets saying they don’t want to be euthanized. Fair is fair. Santorum was wrong. They don’t wear bracelets — they carry please-don’t-euthanize-me cards in their wallets or purses.

Enough. Rick Santorum is exactly right in his broader criticism that the Netherlands as leaping head-first off a vertical moral cliff. Maybe if Dutch reporters paid closer attention to what is happening under their very noses, they’d stop laughing at Santorum’s minor factual errors and start acting like journalists.

Wesley J. Smith is a senior fellow at the Discovery Institute’s Center on Human Exceptionalism. He also consults for the Patients Rights Council and is a special consultant to the Center for Bioethics and Culture.