Physician-Assisted Death in Perspective
Assessing the Dutch Experience

This book is the first comprehensive report and analysis of the Dutch euthanasia experience over the last three decades. In contrast to most books about euthanasia, which are written by authors from countries where the practice is illegal and therefore practised only secretly, this book analyzes empirical data and real-life clinical behavior. Its essays were written by the leading Dutch scholars and clinicians who shaped euthanasia policy and who have studied, evaluated and helped regulate it. Some of them have themselves practised euthanasia. The book will contribute to the world literature on physician-assisted death by providing a comprehensive examination of how euthanasia has been practised and how it has evolved in one specific national and cultural context. It will greatly advance the understanding of euthanasia among both advocates and opponents of the practice.

Introduction Stuart J. Youngner and Gerrit K. Kimsma; Part I. Background and History: 1. The lateness of the Dutch euthanasia debate and its consequences James C. Kennedy; 2. Classifications and definitions: Dutch developments John Legemaate; 3. The legalization of euthanasia in the Netherlands: revolutionary normality Heleen Weyers; 4. The normative context of the Dutch euthanasia law Esther Pans; 5. Dutch social groups on euthanasia: the political spectrum on ending life on request Heleen Weyers; 6. The Dutch social fabric: health care, trust, and solidarity Margo Trappenburg and Hans Oversloot; Part II. Regulation and Practice Deficiencies: 7. The unreported cases Bregje D. Onwuteaka-Philipsen; 8. Physician-assistance in dying without an explicit request by the patient Agnes van der Heide; 9. When requests do not result in euthanasia or assisted suicide Roeline W. Pasman; 10. Dutch euthanasia in retrospect John Griffiths; Part III. Quality Assurance: 11. Euthanasia consultants: professional assessment before euthanasia and physician-assisted suicide in the Netherlands Gerrit K. Kimsma; 12. Reviews after the act: the role and the work of regional euthanasia review committees Gerrit K. Kimsma and Evert Van Leeuwen; 13. Palliative care and physician-assisted death Dick Willems; Part IV. Learning from the Practice: 14. Unbearable suffering and advanced dementia: the moral problems of advance directives for euthanasia Cees M. P. M. Hertogh; 15. Decision making capacity in patients who are in the early stage of Alzheimer's disease and who request physician-assisted suicide Ron Berghmans; 16. Being 'weary of life' as cause for seeking euthanasia of physician-assisted suicide Mette Rurup; 17. Shared obligations and 'medical friendships' in assisted dying: moral and psychological repercussions reconsidered Gerrit K. Kimsma and Chalmers C. Clark; 18. Depression, euthanasia and assisted suicide Marije van der Lee; 19. End-of-life decisions in children and newborns in the Netherlands Pieter J. J. Sauer and A. A. Eduard Verhangen; 20. Hastening death through voluntary cessation of eating and drinking: a survey Boudewijn E. Chabot; Part V. The Challenge of Unbearable Suffering: 21. The subjectivity of suffering and the normativity of unbearableness Henri Wijsbek; 22. Assessment of unbearable and hopeless suffering in evaluating a request to end life Gerrit K. Kimsma; Part VI. Overview: 23. The regulation of euthanasia: how successful is the Dutch system? Govert den Hartogh; 24. No regrets Margo Trappenburg.

Stuart J. Youngner, MD, is the Susan E. Watson Professor and Chair of the Department of Bioethics at Case Western Reserve University School of Medicine. Trained as a psychiatrist, Dr Youngner is a nationally and internationally recognized scholar in biomedical ethics. He has published extensively on topics including end-of-life issues, organ transplantation and the definition of death.
Gerrit K. Kimsma, MD, MPh is a practising physician and philosopher and co-founder of the Department of Metamedicine at Vrije Universiteit, Amsterdam. He is a nationally and internationally recognized scholar in end-of-life issues and serves on the Board of Cambridge Quarterly of Health Care Ethics, Theoretical Medicine and Bioethics, Medicine HealthCare and Philosophy.