End-of-life poses medical and ethical questions which are being debated in many countries, particularly in France.
The three Benelux countries have partially decriminalised euthanasia, defined as "an action which aims at taking the life of another at the latter's expressed request" – the Netherlands since 2001, Belgium since 2002 and Luxembourg since 2009.
In the Netherlands and Luxembourg, but not in Belgium, the law has partially decriminalised assisted suicide as well as euthanasia.
All three countries authorise the act of euthanasia to be carried out solely by a willing doctor at the request of the patient who has given serious thought to the question, in cases of an incurable disease causing unbearable suffering and with no prospect of relief. In Luxembourg and Belgium, the request must be in writing and signed by the patient in person. In the Netherlands, a written request is not formally required, but it is highly recommended. The doctor who performs the euthanasia has a duty to inform the competent authority.
In the Netherlands, minors over the age of 12 can request euthanasia.
In 2011, reported cases of euthanasia represented around 1% of deaths in Belgium and 3% in the Netherlands; 75% of these were cancer cases.
In the Netherlands, investigations reveal that all cases of euthanasia are reported to the authorities. In Belgium, 50% are thought to go unreported. But since the introduction of the law on euthanasia, there has been a decline in the practice of intentional administration of a lethal substance without an explicit request from the patient.
©Prescrire 1 November 2013
"Euthanasia in Belgium, the Netherlands and Luxembourg" Prescrire Int 2013; 22 (143): 274-278. (Pdf, subscribers only).