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Comment by bsandert | Hacker News Reader

I am from the Netherlands. Euthanasia is legal here, although strictly regulated (as I think it should be by the way, this is not the sort of choice that should be taken or approved lightly by anyone involved). Several doctors had to sign off on it, and they were thorough in making sure that this was his decision alone and that nobody around him was "pushing" him into it. Fortunately (if you can call it that), his medical situation was a textbook case of unbearable and hopeless suffering, and also he still had a clear enough mind to express his wishes. That made the approval process fairly straightforward in his case.

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For those wondering what the typical regulations consist of, I found the following article doing a quick google search:

>> In all jurisdictions, the request for euthanasia or pas has to be voluntary, well-considered, informed, and persistent over time. The requesting person must provide explicit written consent and must be competent at the time the request is made. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3070710/

This is fairly comprehensive, which is reassuring. However, the article goes on to say:

>> Despite those safeguards, more than 500 people in the Netherlands are euthanized involuntarily every year. In 2005, a total of 2410 deaths by euthanasia or pas [physician assisted suicide] were reported, representing 1.7% of all deaths in the Netherlands. More than 560 people (0.4% of all deaths) were administered lethal substances without having given explicit consent. For every 5 people euthanized, 1 is euthanized without having given explicit consent.

Just because regulations are strict, does not mean that they are strictly followed, or enforced.

It would be relevant to know, of the 'involuntary' numbers, how many of those were statutory involuntary and for what reasons.

My hope is that in the majority of those cases the paperwork either just didn't get finished in time, or that the subject in some way did actually want this but started the process too late to be clearly of their own decision.

So you're essentially hoping that these people, who did not give explicit consent, actually (and perhaps secretly) did want to be killed?

My hope is that where paperwork did go through, no person was uncertain or regretted their life-altering decision (which, for example, increases suicide risk in one's family twofold). But I doubt that either of our hopes lives up to reality.

> increases suicide risk in one's family twofold

Euthanasia increases suicide risks as opposed to dying painfully of natural causes?

> increases suicide risk in one's family twofold

What is the baseline here? Could you provide a source?

Reading the PDF (http://www.nejm.org/doi/pdf/10.1056/nejmsa071143):

"When life was ended without the explicit request of the patient, there had been discussion about the act or a previous wish of the patient for the act in 60.0% of patients, as compared with 26.5% in 2001. In 2005, the ending of life was not discussed with patients because they were unconscious (10.4%) or incompetent owing to young age (14.4%) or because of other factors (15.3%). Of all cases of the ending of life in 2005 without an explicit request by the patient, 80.9% had been discussed with relatives. In 65.3% of cases, the physician had discussed the decision with one or more colleagues"

So, part of this is due to the fact that the law states that doctors must check that the patient consents _now_ with the choice. A written statement that, for example, one doesn't want to live on with Alzheimer's when one has reached a well-described state is not sufficient.

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