1 "Protection of the Human Rights and Dignity of the Terminally Ill and the Dying," Council of Europe, Recommendation 1418 (1999). Available at: http://assembly.coe.int/Documents/AdoptedText/ta99/erec1418.htm1. The Council of Europe, which should not be confused with the European Union, was established in 1949 in order inter alia to defend human rights. [Back]
5 "Euthanasia Report of the Social, Health and Family Affairs Committee of the Council of Europe." 10th September 2003 (Doc. 9898). http://assembly.coe.int/Documents/WorkingDocs/Doc03/EDOC9898.htm ("Marty I"). [Back]
6 http://www.coe.int/NewsSearch/InternetNewsSearchDateKW.asp?lmLangue=1&qrNewsExpMonth=4&qrNewsExpYear=2004&KW=marty&Submit=Go [Back]
7 "Assistance to Patients at End of Life," Report of the Social, Health and Family Affairs Committee. 9th February 2005 (Doc. 10455) http://assembly.coe.int/Documents/WorkingDocs/Doc05/EDOC10455.htm ("Marty II"). [Back]
8 Marty I (Draft Resolution) para. 1. [Back]
16 B. J. Ward and P. A. Tate, "Attitudes among NHS Doctors to Requests for Euthanasia," British Medical Journal 308 (1994): 1332. [Back]
17 J. Keown, Euthanasia, Ethics and Public Policy (Cambridge UK: Cambridge Univ. Press, 2002), p.94 n22. The three surveys are: P.J. van der Maas, J.M.M. van Delden, L. Pijnenborg, Medische beslissingen rond het levenseinde. Het onderzoek voor de Commissie onderzoek medische praktijk inzake euthanasia (The Hague: SDU Uitgeverij Plantijnstraat, 1991); G. van der Wal, P.J. van der Maas, Euthanasie en andere medische beslissingen rond het levenseinde. De praktijk en de meldingsprocedure (The Hague: SDU Uitgevers, 1996); G. van der Wal, A. van der Heide, B.D. Onwuteaka-Philipsen, and P.J. van der Maas, Medische besluitvorming aan het einde van het leven: De praktijk en de toetsingprocedure euthanasiae (Utrecht: De Tijdstroom, 2003). For an analysis of the first two surveys, see J. Keown, op. cit., Part III. For an analysis of the third, see R. Fenigsen, "Dutch Euthanasia: The New Government Ordered Survey," Issues in Law and Medicine 20 (2004): 73. [Back]
18 S.A.M. McLean and A. Britton, Sometimes a Small Victory (Glasgow: Institute of Law and Ethics in Medicine, 1996) App. III, Table 17, at pp. 31-32. [Back]
19 D.E. Meier et al. "A National Survey of Physician-Assisted Suicide and Euthanasia in the US," New England Journal of Medicine 338 (1998): 1193. [Back]
20 P.J. van der Maas and L.L. Emanuel, "Factual Findings" in Regulating How We Die, ed. L.L. Emanuel (Cambridge MA: Harvard Univ. Press, 1998), p. 151. [Back]
21 Revealingly, the Draft Resolution did not propose that in the light of whatever evidence might emerge from studies into the incidence of euthanasia there be a review of various options, including improvement in the provision of quality palliative care and/or tighter enforcement of the criminal law. It proposed solely that member states consider legalizing euthanasia. That this appeared to be the Report's not too skillfully hidden agenda was also suggested by its underlying argument in principle for reform. For, if there is a right to voluntary euthanasia, why should it not be recognized by law, whatever the evidence about its current incidence? [Back]
22 See generally, New York State Task Force on Life and the Law, When Death is Sought: Assisted Suicide and Euthanasia in the Medical Context (Albany NY: Health Education Services, 1994); J. Keown, op. cit. [Back]
23 L. Roscoe, J. Malphurs, L. Dragovic, and D. Cohen, "Dr. Jack Kevorkian and Cases of Euthanasia in Oakland County, Michigan, 1990-1998," New England Journal of Medicine 343 (2000): 1735-36 (Correspondence). [Back]
24 J. Keown, op. cit., at pp. 113, 132; R. Richard Fenigsen, loc. cit., at pp.73, 77. [Back]
25 Dr. Richard Fenigsen translates the relevant passage on p.201 (ll. 22-27) of the third survey (G. van der Wal, A. van der Heide, B.D. Onwuteaka-Philipsen, and P.J. van der Maas, op. cit.) as follows: "Due consideration should be given to the question how termination of life without explicit request can be prevented. It should be the responsibility of the patients, (their) next of kin, the doctors, the nurses, and the management, to clarify, well in advance, orally and in writing what are the wishes of the patient concerning the end of his life; for example, as a statement of will or as advance care planning." ["Het verdient overweging om na te gaan op welke wijze levensbeeindigend handelen zonder uitdrukkelijk verzoek kan worden voorkomen. Hier ligt een veraantwoordelijkheid voor patienten, naasten, artsen, verpleging en management, om vroegtijdig, mondeling en schriftelijk, duidelijkheid te creeren over de wensen van de patient met betrekking tot diens levenseinde, bijvoorbeeld door middel van wilsverklaringen en advance care planning."] I am grateful to Dr. Fenigsen for this translation (Personal communication, 31st January 2005). [Back]
26 Marty I (Explanatory Memorandum) at para. 20-24. [Back]
27 See, for example, C.F. Gomez, Regulating Death: Euthanasia and the Case of the Netherlands (New York NY: Free Press, 1991); H. Hendin, Seduced by Death: Doctors, Patients and Assisted Suicide (New York NY: W.W. Norton 1998); J. Keown, op. cit. The focus in this chapter is on the Dutch rather than the Belgian experience, partly because Dutch law has approved euthanasia for much longer (and there is accordingly more evidence about Dutch practice) and partly because the Belgian law largely emulates the Dutch law. [Back]
28 http://www.unhchr.ch/tbs/doc.nsf/(Symbol)/CCPR.CO.72.NET.En?Opendocument para. 5-6. [Back]
29 J. Keown, op. cit., at pp. 64-66. [Back]
30 Regina (Pretty) v Director of Public Prosecutions (Secretary of State for the Home Department Intervening) [2002] 3 WLR 1598. His Lordship stated (at paragraph [35]): "Suicide itself (and with it attempted suicide) was decriminalised because recognition of the common law offence was not thought to act as a deterrent, because it cast an unwarranted stigma on innocent members of the suicide's family and because it led to the distasteful result that patients recovering in hospital from a failed suicide attempt were prosecuted, in effect, for their lack of success. But while the 1961 Act abrogated the rule of law whereby it was a crime for a person to commit (or attempt to commit) suicide, it conferred no right on anyone to do so. Had that been its object there would have been no justification for penalising by a potentially very long term of imprisonment one who aided, abetted, counselled or procured the exercise or attempted exercise by another of that right. The policy of the law remained firmly adverse to suicide, as section 2(1) makes clear." [Back]
31 Report of the House of Lords Select Committee on the Assisted Dying for the Terminally Ill Bill, HL Paper 86-I (2005), para. 232. [Back]
33 Marty I (Explanatory Memorandum) at para 8. [Back]
34 Yet Marty boldly asserted that withdrawal is "an act of commission, if ever there was one." Ibid., at para. 59. [Back]
38 Ibid. (Draft Resolution) at para. 9(iv) [Back]
39 CNN.COM/WORLD 14th April 2001. [Back]
40 A hearing that, like the Report, was unbalanced: invited speakers in favor of legalization markedly outnumbered those against. [Back]
41 J. Jochemsen, "Dutch Court Decisions on Nonvoluntary Euthanasia Critically Reviewed" Issues in Law & Medicine 13/4 (1998): 447. [Back]
42 T. Sheldon, "Dutch Doctors Adopt Guidelines on Mercy Killing of Newborns" British Journal of Medicine 331 (2005): 126. [Back]
43 Marty I (Explanatory Memorandum) at para. 62. [Back]
45 "Euthanasia: An Opinion by the Committee on Legal Affairs and Human Rights." 23rd September 2003 (Doc 9923). Rapporteur: Mr Kevin McNamara, U.K., Socialist Group. (ALegal Opinion@). http://assembly.coe.int/Documents/WorkingDocs/Doc03/EDOC9923.htm. [Back]
46 Legal Opinion (Explanatory Memorandum) para. 4. [Back]
47 http://www.coe.int/NewsSearch/InternetNewsSearch.asp?KW=marty+&lmLangue=1&Submit=Search&L. [Back]
48 "Assistance to Patients at End of Life," Report of the Social, Health and Family Affairs Committee, 9th February 2005 (Doc. 10455) http://assembly.coe.int/Documents/WorkingDocs/Doc05/EDOC10455.htm ("Marty II"). [Back]
49 Marty II (Draft Resolution) at para. 1. [Back]
50 Ibid., at para. 6(v). [Back]
51 In his conclusions Mr. Marty commented that the answer to the questions he raised about patient autonomy, dignity, and the practice of secret euthanasia should "not necessarily" be the legalization of euthanasia, at least as a solution applicable to all members states (ibid., explanatory memorandum, at para. 49). It seems clear, however, that "not necessarily" for "everyone" did not mean "not" for "anyone." [Back]
54 E.K. Emanuel, "The History of Euthanasia Debates in the United States and Britain," Annals of Internal Medicine 121/10 (1994): 793. [Back]
56 "Report of the House of Lords Select Committee on Medical Ethics," HL Paper 21-I (1994). [Back]
58 Pretty v United Kingdom (2002) 66 BMLR 147, ECtHR. [Back]
59 Marty II (Explanatory Memorandum) at para. 51. [Back]
60 Legal Opinion (Conclusions of the Committee) Amendment D. [Back]
61 Marty II (Explanatory Memorandum) at paras. 26-30; 51. [Back]
62 Legal Opinion (Conclusions of the Committee) Amendment E. [Back]
63 Marty II (Explanatory Memorandum) at para. 48 n15. [Back]
64 http://www.coe.int/NewsSearch/InternetNewsSearchDateKW.asp?lmLangue=1&qrNewsExpMonth=04&qrNewsExpYear=2005&KW=marty&Submit=Go [Back]
1, 2,