Unlawful euthanasia or assisted suicide

An illegally performed euthanasia is an independent criminal offense (art. 293 Sr). When in doubt about the patient's wishes, it can even be classified as murder. The same applies to assisted suicide (art. 294 Sr). As a doctor, it is therefore crucial that you comply with the rules surrounding euthanasia and assisted suicide. The most important of these are laid down in the requirements of care as described in the Act on the Assessment of the Termination of Life at Request and Assisted Suicide (WTL).

• In euthanasia, a doctor administers a lethal agent to the patient.

• In assisted suicide, the doctor gives a lethal drug to the patient. But the patient takes that drug himself.

Sometimes the word "euthanasia" is used for both forms of helping with dying.

• Voluntary and deliberate request: The doctor performing the euthanasia must be satisfied that that was a voluntary and deliberate request by the patient.

• Hopeless and unbearable suffering: The patient must be suffering from a medically hopeless situation accompanied by unbearable suffering.

• Informing the patient: The physician must have fully informed the patient of his situation and outlook.

• No reasonable other solution: There must be no reasonable other solution to the patient's situation.

• Consultation: At least one other, independent physician (the SCEN physician) must have seen the patient (also) and must have assessed in writing whether the standards of care have been met.

• Careful execution: Termination of life or assisted suicide must be performed with medical care.

After a euthanasia, the coroner will report it to the one of the five Regional Euthanasia Review Committees (RTE). The RTE then tests whether the euthanasia/assisted suicide took place in accordance with the applicable standards of care. If that is the case, the doctor is notified. The case is labeled "acted in accordance with the requirements of care" and can be filed.

If the RTE is of the opinion that the standard of care was not met, it will inform - in addition to the doctor - the Health Care and Youth Inspectorate (IGJ) and the Board of Procurators General. These then decide whether the doctor will also face disciplinary or criminal prosecution.

The RTE's reviews can be found on their website.

The prosecution policy for prosecution following negligent euthanasia is laid down in the Aanwijzing vervolingsbeslinding inzake actieve levensbeëindiging op verzoek (euthanasia and assisted suicide).. Not every negligent euthanasia will be criminally prosecuted. In principle, however, this is the case when a "substantial standard of care" is violated. Substantive standards of care include the requirement that the request be voluntary and deliberate and the requirement that the suffering be hopeless and unbearable.