Select Page

DUTCH DOCTORS SEE TERMINAL SEDATION AS ALTERNATIVE TO EUTHANASIA — A new survey of Dutch doctors reveals that advances in pain management have helped somewhat to mute the call for euthanasia in the Netherlands. But others see the idea as a different form of euthanizing patients. While euthanasia is legal in the European country, physicians appear to be increasingly receptive to using sedation to end the suffering of a terminally ill patient, according to the author of the survey. Nijmegen University professor Bernardus Crul, who conducted the survey of 1,500 doctors, told the Dutch Evangelical Broadcasting Network that enhanced care for the dying and better methods of pain control have undermined the case for euthanasia. “Most doctors no longer see euthanasia as a medical necessity for fighting unbearable suffering and that the solution of terminal sedation is suitable for that,” Crul told the network.
With terminal sedation, a patient is medicated in order to achieve an unconscious state. All treatment, food and water are withheld from a terminally ill patient under sedation. While some see terminal sedation as an alternative to euthanasia, critics have called it “slow euthanasia,” claiming that is like a slow-motion form of homicide. For ethicists, where sedation is concerned, the issue becomes whether the physician’s goal is to relieve pain or to hasten death. “There is an important ethical distinction between giving pain relief, even to the point of complete sedation, and denial of food and fluids,” said Burke Balch, Director of National Right to Life’s Robert Powell Center for Medical Ethics. “In the exceedingly rare cases in which pain cannot otherwise be controlled, it may be legitimate to sedate even to unconsciousness, preferably temporarily. That is different from starving and dehydrating someone in order to bring about death, and then sedating the patient to avoid the pain associated with this rather terrible way to die,” Balch added. Meanwhile, Nancy Valko of Nurses for Life questions the motivations of Dutch physicians who use terminal sedation. “This article makes me wonder if Dutch doctors are performing terminal sedation or withdrawal of treatment because it is less hard on their consciences,” Valko said. “Killing someone would bother the average person, so why would doctors be immune even though they might deny it,” she added. Valko notes that terminal sedation is also rapidly gaining ground in the U.S. She points to an article written by Dr. Erich Lowry called, “Terminal Sedation, Self-starvation, and Orchestrating the End of Life,” which appeared in a 2001 edition of the Archives of Internal Medicine.Dr. Lowry wrote, “The claim is made that such a way of proceeding is aimed at providing maximal relief of pain and suffering — the death of the patient is ‘not intended.’ But that is, to say the least, disingenuous. ” “Patients are intentionally kept asleep, their vital functions are deliberately not artificially supported, and they are allowed to die in comfort. That they should die in comfort is clearly the goal — and I would argue the legitimate goal — of terminal sedation.” Lowry wrote.Under the Dutch euthanasia law, patients are eligible for “mercy killing” if they face a future of “unbearable suffering” and make a voluntary request to die. According to Reuters, the doctor and patient must be “convinced there is no other solution” and a second doctor must be consulted prior to the killing. [Amsterdam, Netherlands, Maria Gallagher June 2, 2004; Ertelt,, 3Jun04, #3275]  Related web sites: National Right to Life –