Word: euthanasia
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...Dutch claim their system has built-in safeguards. For one, most people still rely on a family doctor,which reduces the risk of routinized euthanasia by an impersonal system. For another, Holland's welfare state is alive and well. Nursing care for the chronically ill is good, and everyone's medical expenses are covered, so finances are not a factor...
What about the 900 people euthanized without asking for it? Admits Van der Wal, "We don't like these cases, but we don't deny them either." The study found that about half the patients had earlier discussed euthanasia. Many were in great pain in the last days of life and were given morphine, which eased their suffering but also hastened death. The government has proposed tighter controls of these nonrequest cases, but practitioners say Holland's candor has merely thrown light on a common, if little discussed, medical practice. "Doctors all over the world shorten the lives of patients...
Keizer says he grants only one of the five or so "serious" euthanasia requests he gets a year. "The process is so stressful that most physicians do whatever they can to avoid getting involved in euthanasia cases," he says. "It's still as emotional and difficult as ever, but the current climate makes it easier to discuss with the patient...
That's just the problem, insists Amsterdam psychiatrist Frank Koerselman, one of the few in Holland to buck the consensus. "Patients are scared by pain and the loss of their dignity, so they immediately start talking about active euthanasia," he said. "They are badly informed about alternatives." In particular, says oncologist Zbigniew Zylicz, who runs a hospice for dying cancer victims outside Arnhem, "the knowledge and practice are very low for palliative care," the art of easing pain in the final stage of a terminal illness. Zylicz estimates that a quarter of the 400 or so dying patients...
...many terminally ill patients and their families, it's having the option that counts. When Annemie Douwes Dekker's husband Hink was first told he had multiple sclerosis in 1978, his family doctor agreed to discuss the possibilities of euthanasia if and when the time came. "That was a great help to us," Annemie recalled. Five years later Hink, then 50, had been in a nursing home for a year and was deteriorating rapidly, losing his ability to communicate and control bodily functions. Yet, says his widow, now 62 and living in Haarlem, "he had a strong heart; he could...