Euthanasia EU

[Toastie]

My country doesn't allow assisted suicide. It is in the EU tho, is it possible to get approval in say.. Netherlands for example and just travel down to go through the process?

 

[anxiousdweller]

As a non citizen i dont think its possible and even if it was its a strict program where you really have to go through a lengthy progress with all the other options tried "to get better" so conclusion its not possible

 

[Chronic]

Switzerland

 

[Talvikki]

My country doesn't allow assisted suicide. It is in the EU tho, is it possible to get approval in say.. Netherlands for example and just travel down to go through the process?

Theoretically, someone living abroad could receive euthanasia in the Netherlands, but due to administrative, ethical, legal and practical difficulties, this almost never happens.

Administrative barriers
For euthanasia in the Netherlands, you need a Dutch-based doctor, a Dutch Citizen Service Number (BSN), and Dutch health insurance.

Practical problems
The euthanasia procedure must take place in the Netherlands, but so must the consultations leading up to it. This is difficult if you live in another country. Moreover, the Euthanasia Expertise Centre primarily focuses on people living in the Netherlands.

Medical and ethical considerations
Dutch doctors are often unwilling to assist with a euthanasia request from abroad. For them, euthanasia is the endpoint of long-term care and cannot be provided lightly.

Legal requirements
Your request must comply with Dutch law. For instance, the doctor must be certain that your request is voluntary and well-considered, that you are suffering unbearably and hopelessly from a medical perspective, and that no other treatments are available. This requires good communication. Without a reliable medical history or in the case of language barriers, a doctor will not perform euthanasia.

Medical resistance
Doctors and medical associations want to prevent the Netherlands from becoming a destination for 'euthanasia tourism'. They do not wish to encourage this in any way.


Frequently asked questions

You live in the Netherlands

I live in the Netherlands but have a different nationality. Can I request euthanasia?
Yes, you can, as long as you live in the Netherlands. You will need Dutch health insurance and a Dutch Citizen Service Number (BSN). Your request must also meet all legal requirements.


Can I go to the Euthanasia Expertise Centre without having Dutch nationality?
Yes, you can if you live in the Netherlands. But only if your request for euthanasia has been rejected by your own doctor. Read more about this here.


You live in the the European Union
Even if it is possible to find a physician who is willing to perform euthanasia to someone coming from abroad, the costs of the procedure are only reimbursed for people with Dutch health insurance whose health insurance policy does not exclude euthanasia. If the procedure is not covered by the patient's health insurance policy, the costs will be charged to the deceased's estate.

People who live in another European Union member state who wish to request euthanasia in the Netherlands but do not have Dutch health insurance should ask their own health insurer in advance whether they will reimburse the costs of euthanasia in the Netherlands. Without such prior authorisation, there is no right to reimbursement and the costs of the euthanasia procedure will be charged to the deceased's estate.

The Dutch Euthanasia Expertise Centre (Expertisecentrum Euthanasie) provides counselling and support to physicians with patients who have requested euthanasia. The Centre also helps patients whose physician, for reasons of their own, cannot perform euthanasia. However, the Centre explicitly states that they only accept applications from people who:

- have a residential address in the Netherlands
- are registered with a general practitioner in the Netherlands
- have Dutch health insurance, and
- have a good command of Dutch and/or English.


Request for euthanasia from patients living abroad

A doctor performing euthanasia on a patient must check whether all due care criteria set out in the law are met.

To do this, the doctor must know the patient's medical history. The doctor must be able to conclude that the patient is suffering hopelessly, and that no other treatments are possible. The doctor must also be certain that the patient has carefully considered the request, and that the suffering is unbearable for the patient.

When a patient from abroad requests euthanasia, the Dutch doctor must also consider the six legal requirements. If someone lives abroad, it may be more difficult for the Dutch doctor to properly know the patient's medical history, and to assess whether all legal requirements align with the patient's situation.

The doctor decides independently on a euthanasia request from someone living abroad. The doctor also decides how to determine whether the euthanasia request meets the six due care criteria set out in the law – for example, by consulting with healthcare providers who are or have been treating the patient.


The 6 due care criteria of the euthanasia law

The euthanasia law specifies when a doctor may assist with euthanasia or assisted suicide. The doctor must comply with all 6 due care criteria set out in the law. The law also stipulates how the doctor's work should be reviewed afterwards.


6 due care criteria

The 6 due care criteria a doctor must adhere to in euthanasia or assisted suicide are:

1. Voluntary and well-considered

The doctor must be convinced that the patient's request for euthanasia is voluntary and that the patient has carefully considered it (well-considered). The request must truly come from the patient themselves. No one may coerce or pressure the patient – not family, not friends. Also, the request must not arise suddenly, as the wish for euthanasia could then also disappear just as quickly. Therefore, discuss the euthanasia wish with your (family) doctor in good time and regularly.


2. Hopeless and unbearable suffering

The doctor must be convinced that the patient is suffering hopelessly and unbearably. In assessing hopelessness, the patient's illness or condition and the prognosis play an important role. Suffering is hopeless if:

· the patient can no longer be cured;
· it is not possible to alleviate the patient's suffering.

The doctor also considers how much improvement a treatment can still provide, and how burdensome the treatment is for the patient.

Unbearable suffering concerns how the patient experiences the suffering. This differs for everyone. The doctor must be able to understand that the suffering is unbearable for the patient.

3. Informing about the situation and prognosis

The doctor must provide the patient with information about their health situation and what the patient's situation will look like in the future. It is important that the patient understands all the information about their situation, so they can make a good decision. The doctor must verify whether the patient knows enough and whether the patient has understood the information.

4. No reasonable alternative solution

The doctor must decide together with the patient that there is no reasonable alternative solution for the patient's situation. The doctor must always consider whether there are no other ways to alleviate the suffering. This does not mean that the patient must try all possible treatments.

Does a particular treatment cause the patient a lot of discomfort and pain? Then that is taken into account in the assessment. Sometimes a treatment is very burdensome but only improves the patient's situation slightly. Then the doctor and patient may decide together to stop the treatment.

5. Consulting an independent doctor

The patient's doctor must consult at least one independent doctor. This doctor is called a consultant. The consultant must see the patient and assess whether the doctor has adhered to the due care criteria. Independence means the consultant may give their own opinion about the patient and the doctor. The consultant may not be involved in the patient's treatment, nor have a personal relationship with the doctor or the patient.

6. Medically careful execution

Finally, the doctor must perform the euthanasia (or assisted suicide) in a medically careful manner, for example using the correct medication and following the proper steps. For this purpose, doctors and pharmacists have drawn up a guideline: 'Performing euthanasia and assisted suicide'. The guideline sets out requirements for how doctors should properly perform euthanasia and assisted suicide.


Links:

Government of the Netherlands
https://www.government.nl/topics/euthanasia/is-euthanasia-allowed

Euthanasia Expertise Centre
https://expertisecentrumeuthanasie.nl/en/