Santorum sparks controversy over Dutch euthanasia


Although it is not widely known in the international bioethics community, Australian Rules Football is the World’s Greatest Game. Without defending this thesis with the vigour it deserves for lack of space, we note that there are two ways to score: through the goal posts for a 6 point goal, or on either side, for a 1 point behind.

So when US presidential hopeful Rick Santorum described the state of euthanasia in the Netherlands on February 3 in a forum in Missouri, he failed to kick a goal. In fact, the Washington Post fact checker, who is the son of Dutch migrants and whose uncle was euthanased, disparaged his “bogus statistics” and awarded him four Pinicchios.  He was ridiculed in the New York Times and on Radio Netherlands. 

Intriguingly, however, the Dutch embassy declined to scold Mr Santorum for the inaccuracy of his remarks. Instead it passed on to the Times a bundle of “documents and official statistics” which purported to show that “there are no provisions of Dutch law that permit forced euthanasia”.

Perhaps the embassy wanted to avoid the scrutiny of euthanasia in the Netherlands that an open confrontation with a presidential candidate would have entailed. Because it then would have become clear that the problem with official Dutch statistics is that they, too, are bogus and that the Dutch notion of law accommodates numerous exceptions.

The government itself has acknowledged that many doctors ignore the law. At one stage, the Dutch health minister resorted to pleading with doctors to report all cases of euthanasia after numbers dropped for four years in a row. The picture is further confused by the fact that there has been a hefty increase in what is called "terminal sedation". Patients are given drugs which sedate them "continuously and deeply" until death -- a kind of slow euthanasia. 

Nor are all euthanasia deaths voluntary. According to the Groningen Protocol, seriously ill infants may be euthanased with their parents’ consent. This is not voluntary euthanasia. Demented patients and patients with psychiatric illnesses may be euthanased, even though their consent is clearly impaired.

Mr Santorum claimed that patients wear bracelets which say “don’t euthanase me”. This claim is hard to verify. But it is true that a “living will” means something quite different in US than it does in the Netherlands. In the US, it normally means “please withhold burdensome treatment”; in the Netherlands, a group called the Nederlandse Patiënten Vereniging (Dutch Patients’ Association) feels it necessary to distribute a Levenswensverklaring, a desire-to-live statement.

So, while Mr Santorum was playing fast and loose with his facts about euthanasia in the Netherlands, he was not completely off the mark. As Australians might say, he kicked a Dutch behind. 

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