The figures might be seen as showing that palliative sedation, also known as terminal sedation, has replaced euthanasia in many cases. But According to Ruben van Coevorden, an Amsterdam GP specialising in palliative care and end-of-life issues, this is certainly not the case. He says that palliative care is no alternative for euthanasia.
"With euthanasia, people make a deliberate choice. They say I don't want to go on, I can't take it any more, and they ask the doctor to help them die. This is entirely different from palliative sedation, which involves people who are nearly at the end of their lives and are suffering severe distress because of an illness."
 |
 |
|
Listen to Ruben van Coevorden talking to Louise Dunne |
|
Nevertheless, opponents of euthanasia in particular are interpreting the figures as an indication that palliative care and sedation are an alternative to euthanasia. Esmé Wiegman-Van Meppelen Scheppink, a member of parliament for the Christian Union, is one of them. "I'm very pleased about these figures," she says. "We've always said you have to consider the underlying motives of people who request euthanasia." "They're often suffering intolerable pain, or psychological or social problems. We think that at the end of life, adequate treatment should be provided to relieve this pain. That's the role of palliative care, and palliative sedation is a part of it."
 |
|
Agnes Kant of the SP |
Other political parties also think the figures show that palliative sedation provides an alternative to euthanasia. But according to members of parliament Anouchka van Miltenburg of the conservative VVD and Agnes Kant of the Socialist Party, care needs to be taken that doctors don't use palliative sedation out of laziness.
Unlike with euthanasia, there is no obligation for doctors to report the use of palliative sedation. But Ms Van Miltenburg thinks the route to euthanasia should not be cut off.
Dr Van Coevorden believes there is little danger of this happening. The argument should be seen the other way round. Improved palliative care means that fewer people have to resort to euthanasia. It is not that the route to euthanasia is cut off, but that people are no longer forced to take it. "There is simply a lot more experience and knowledge of palliative care today,"says Dr Van Coevorden. "People now receive better care. In the past, they were driven to euthanasia out of impotence, because we didn't know what else to do. Now it's only needed when people are so decrepit they just don't want to go on."Dr Van Coevorden expects that because of improvements in the care for terminally ill patients, the incidence of euthanasia will continue to fall over the coming years - but it will never disappear entirely.
*RNW Translation (mb/cc)
Tags: doctor, euthanasia, lethal drugs, number of cases, palliative care, sedation