Death on wheels

Edith Schippers, Dutch health ministerStraight from the “just when you thought it couldn’t possibly get any worse” files come reports that the Dutch Health Minister admitted in their parliament recently that her department is “considering” setting up mobile euthanasia death squads.
Minister Edith Schippers (pictured) is quoted in the UK Telegraph as saying that mobile units "for patients who meet the criteria for euthanasia but whose doctors are unwilling to carry it out" was worthy of consideration.
Instantly, many will be reminded of the SS Einsatzgruppen death squads that moved through towns on the Eastern Front following the Nazi invasion of Russia in 1941. I hesitate to draw any further comparison with this dark and sinister period in European history, but this recent development is disturbing on a number of levels.
The suggestion that these mobile units would euthanase people where the local doctor was not willing to do the killing could constitute a serious breach of medical ethics. What if the doctor would not kill for sound medical reasons such as untreated depression or evidence of coercive pressure? Will his or her advice be sought and will his opinion and treatment plan prevail? It doesn’t seem that likely.
Already we have seen Dutch patients with Alzheimer’s being euthanased. But Dutch pro-euthanasia groups are known to want to expand the eligibility for euthanasia further; the UK Daily Mail reports the lobby as saying “that 80 per cent of people with dementia or mental illnesses were being ‘missed' by the country’s euthanasia laws’.” Missed? Is there a door-to-door search? Quick, hide Grandma in the cupboard!
Would the patient’s doctor even be told that the death squad was about to visit his patient? For the frail, elderly or those with depression or mental illness, the doctor may well also be the patient’s only advocate. Doctor shopping for a preferred diagnosis is one thing, but this is death as a door-to-door salesman!
A salesman it is. In Washington State, where assisted suicide is legal, advocates like the euphemistically titled “Compassion and Choices” provide advice to those seeking death in how to approach their doctor and what to do if he or she tries to talk the patient out of it or tries to defer the conversation. Their advice suggests that any answer other than supporting the provision of assisted suicide under their Dignity With Dying Act is unacceptable. But again, is it not a legitimate role of the doctor to avoid a direct answer on such a question with the aim of taking the time to conduct a proper medical and mental health assessment and the best outcome for the patient?
Of course, if you don’t get what you want, there’s always help at the other end of the phone: “... call Compassion & Choices of Washington (C&C) and request a Client Support Volunteer who can help you achieve a peaceful, humane death.” One can easily imagine a similar line being adopted in Holland: “Your doctor said no. How terrible! Here, call the mobile hotline now! Paul Russell is the Director of HOPE: Preventing Euthanasia & Assisted Suicide and is based in South Auustralia. He is also Vice Chair, International Euthanasia Prevention Coalition.


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