APPENDIX
Termination of Life on Request and Assisted
Suicide (Review Procedures) Act
CHAPTER I. DEFINITIONS
Section 1
For the purposes of this Act, the following
definitions shall apply:
(a) Our Ministers: the Minister of Justice
and the Minister of Health, Welfare and Sport;
(b) assisted suicide: intentionally helping
another person to commit suicide or providing him with the means
to do so as referred to in article 294, paragraph 2, second sentence,
of the Criminal Code;
(c) the attending physician: the physician
who, according to the notification, has terminated life on request
or has provided assistance with suicide;
(d) the independent physician: the physician
who has been consulted about the attending physician's intention
to terminate life on request or to provide assistance with suicide;
(e) the care providers: the persons referred
to in article 446, paragraph 1, of Book 7 of the Civil Code;
(f) the committee: a regional review committee
as referred to in section 3;
(g) regional inspector: a regional inspector
employed by the Health Care Inspectorate of the Public Health
Supervisory Service.
CHAPTER II. DUE
CARE CRITERIA
Section 2
1. In order to comply with the due care
criteria referred to in article 293, paragraph 2, of the Criminal
Code, the attending physician must:
(a) be satisfied that the patient has made
a voluntary and carefully considered request;
(b) be satisfied that the patient's suffering
was unbearable, and that there was no prospect of improvement;
(c) have informed the patient about his situation
and his prospects;
(d) have come to the conclusion, together
with the patient, that there is no reasonable alternative in the
light of the patient's situation;
(e) have consulted at least one other, independent
physician, who must have seen the patient and given a written
opinion on the due care criteria referred to in (a) to (d) above;
and
(f) have terminated the patient's life or
provided assistance with suicide with due medical care and attention.
2. If a patient aged sixteen or over who
is no longer capable of expressing his will, but before reaching
this state was deemed capable of making a reasonable appraisal
of his own interests, has made a written declaration requesting
that his life be terminated, the attending physician may comply
with this request. The due care criteria referred to in subsection
1 shall apply mutatis mutandis.
3. If the patient is a minor aged between
sixteen and eighteen and is deemed to be capable of making a reasonable
appraisal of his own interests, the attending physician may comply
with a request made by the patient to terminate his life or provide
assistance with suicide, after the parent or parents who has/have
responsibility for him, or else his guardian, has or have been
consulted.
4. If the patient is a minor aged between
twelve and sixteen and is deemed to be capable of making a reasonable
appraisal of his own interests, the attending physician may comply
with the patient's request if the parent or parents who has/have
responsibility for him, or else his guardian, is/are able to agree
to the termination of life or to assisted suicide. Subsection
2 shall apply mutatis mutandis.
CHAPTER III. REGIONAL
REVIEW COMMITTEES
FOR THE
TERMINATION OF
LIFE ON
REQUEST AND
ASSISTED SUICIDE
Division 1: Establishment, composition and appointment
Section 3
1. There shall be regional committees to
review reported cases of the termination of life on request or
assisted suicide as referred to in article 293, paragraph 2, and
article 294, paragraph 2, second sentence, of the Criminal Code.
2. A committee shall consist of an odd number
of members, including in any event one legal expert who shall
also chair the committee, one physician and one expert on ethical
or moral issues. A committee shall also comprise alternate members
from each of the categories mentioned in the first sentence.
Section 4
1. The chair, the members and the alternate
members shall be appointed by Our Ministers for a period of six
years. They may be reappointed once for a period of six years.
2. A committee shall have a secretary and
one or more deputy secretaries, all of whom shall be legal experts
appointed by Our Ministers. The secretary shall attend the committee's
meetings in an advisory capacity.
3. The secretary shall be accountable to
the committee alone in respect of his work for the committee.
Division 2: Resignation and dismissal
Section 5
The Chair, the members and the alternate members
may tender their resignation to Our Ministers at any time.
Section 6
The chair, the members, and the alternate members
may be dismissed by Our Ministers on the grounds of unsuitability
or incompetence or other compelling reasons.
Division 3: Remuneration
Section 7
The chair, the members and the alternate members
shall be paid an attendance fee and travel and subsistence allowance
in accordance with current government regulations, insofar as
these expenses are not covered in any other way from the public
purse.
Division 4: Duties and responsibilities
Section 8
1. The committee shall assess, on the basis
of the report referred to in section 7, subsection 2 of the Burial
and Cremation Act, whether an attending physician, in terminating
life on request or in assisting with suicide, acted in accordance
with the due care criteria set out in section 2.
2. The committee may request the attending
physician to supplement his report either orally or in writing,
if this is necessary for a proper assessment of the attending
physician's conduct.
3. The committee may obtain information
from the municipal pathologist, the independent physician or the
relevant care providers, if this is necessary for a proper assessment
of the attending physician's conduct.
Section 9
1. The committee shall notify the attending
physician within six weeks of receiving the report referred to
in section 8, subsection 1, of its findings, giving reasons.
2. The committee shall notify the Board
of Procurators General of the Public Prosecution Service and the
regional health care inspector of its findings:
(a) if the attending physician, in the committee's
opinion, did not act in accordance with the due care criteria
set out in section 2; or
(b) if a situation occurs as referred to
in section 12, last sentence, of the Burial and Cremation Act.
The committee shall notify the attending physician accordingly.
3. The time limit defined in the first subsection
may be extended once for a maximum of six weeks. The committee
shall notify the attending physician accordingly.
4. The committee is empowered to explain
its findings to the attending physician orally. This oral explanation
may be provided at the request of the committee or the attending
physician.
Section 10
The committee is obliged to provide the public
prosecutor with all the information that he may require:
1. For the purpose of assessing the attending
physician's conduct in a case as referred to in section 9, subsection
2; or
2. For the purposes of a criminal investigation.
The committee shall notify the attending physician
that it has supplied information to the public prosecutor.
Division 6: Procedures
Section 11
The committee shall be responsible for making
a record of all reported cases of termination of life on request
or assisted suicide. Our Ministers may lay down further rules
on this point by ministerial order.
Section 12
1. The committee shall adopt its findings
by a simple majority of votes.
2. The committee may adopt findings only
if all its members have taken part in the vote.
Section 13
The chairs of the regional review committees
shall meet at least twice a year in order to discuss the methods
and operations of the committees. A representative of the Board
of Procurators General and a representative of the Health Care
Inspectorate of the Public Health Supervisory Service shall be
invited to attend these meetings.
Division 7: Confidentiality and disqualification
Section 14
The members and alternate members of the committee
are obliged to maintain confidentiality with regard to all the
information that comes to their attention in the course of their
duties, unless they are required by a statutory regulation to
disclose the information in question or unless the need to disclose
the information in question is a logical consequence of their
responsibilities.
Section 15
A member of the committee sitting to review
a particular case shall disqualify himself and may be challenged
if there are any facts or circumstances which could jeopardise
the impartiality of his judgment.
Section 16
Any member or alternate member or the secretary
of the committee shall refrain from giving any opinion on an intention
expressed by an attending physician to terminate life on request
or to provide assistance with suicide.
Division 8: Reporting requirements
Section 17
1. By 1 April of each year, the committees
shall submit to Our Ministers a joint report on their activities
during the preceding calendar year. Our Ministers may lay down
the format of such a report by ministerial order.
2. The report referred to in subsection
1 shall state in any event:
(a) the number of cases of termination of
life on request and assisted suicide of which the committee has
been notified and which the committee has assessed;
(b) the nature of these cases;
(c) the committee's findings and its reasons.
Section 18
Each year, when they present their budgets to
the States General, Our Ministers shall report on the operation
of the committees on the basis of the report referred to in section
17, subsection 1.
Section 19
1. On the recommendation of Our Ministers,
rules shall be laid down by order in council on:
(a) the number of committees and their powers;
2. Further rules may be laid down by Our
Ministers by or pursuant to order in council with regard to:
(a) the size and composition of the committees;
(b) their working methods and reporting procedures.
CHAPTER IV. AMENDMENTS
TO OTHER
LEGISLATION
Section 20
The Criminal Code shall be amended as follows.
A
Article 293 shall read as follows:
Article 293
1. Any person who terminates another person's
life at that person's express and earnest request shall be liable
to a term of imprisonment not exceeding twelve years or a fifth-category
fine.
2. The act referred to in the first paragraph
shall not be an offence if it is committed by a physician who
fulfils the due care criteria set out in section 2 of the Termination
of Life on Request and Assisted Suicide (Review Procedures) Act,
and if the physician notifies the municipal pathologist of this
act in accordance with the provisions of section 7, subsection
2 of the Burial and Cremation Act.
B
Article 294 shall read as follows:
Article 294
1. Any person who intentionally incites
another to commit suicide shall, if suicide follows, be liable
to a term of imprisonment not exceeding three years or to a fourth-category
fine.
2. Any person who intentionally assists
another to commit suicide or provides him with the means to do
so shall, if suicide follows, be liable to a term of imprisonment
not exceeding three years or a fourth-category fine. Article 293,
paragraph 2 shall apply mutatis mutandis.
[Sections 21-22 omitted]
CHAPTER V. CONCLUDING
PROVISIONS
Section 23
This Act shall enter into force on a date to
be determined by Royal Decree.
Section 24
This Act may be cited as the Termination of
Life on Request and Assisted Suicide (Review Procedures) Act.
REFERENCES
| 1 | See Appendix below at 319 for the full text of the present Dutch Act.
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| 7 | Legemaate J, "Legal Aspects of Euthanasia and Assisted Suicide in The Netherland 1973-1994" (1995) 4 Cambridge Quarterly of Healthcare Ethics 112. See the Postma Case, Regional Court of Leeuwarden, 21 February 1973, Nederlandse Jurisprudentie 1973, 183.
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| 2 | See the Schoonheim case, Dutch Supreme Court, 27 November 1984, Nederlandse Jurisprudentie 1985, 106.
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| 3 | See below at 314.
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| 4 | Dillmann RJM, "Euthanasia in The Netherlands: The Role of the Dutch Medical Profession" (1996) 5 Cambridge Quarterly of Healthcare Ethics 100.
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| 5 | Hurst SA and Mauron A, "Assisted Suicide and Euthanasia in Switzerland: Allowing a Role for Non-physicians" (2003) 326 British Medical Journal 271.
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| 6 | Dutch Supreme Court, 21 June 1994, Nederlandse Jurisprudentie 1994, 656.
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| 7 | Griffiths J, "Assisted Suicide in the Netherlands: The Chabot Case" (1995) 58 Modern Law Review 232.
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| 8 | Sheldon T, "Being `Tired of Life' is Not Grounds for Euthanasia" (2003) 326 British Medical Journal 71.
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| 9 | Onwuteaka-Philipsen BD, van der Heide A, Koper D et al, "Euthanasia and Other End-of-life Decisions in The Netherlands in 1990, 1995 and 2001" (2003) 362 The Lancet 395.
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| 10 | van der Wal G, "Unrequested Termination of Life: Is It Permissible ?" (1993) 7 Bioethics 330.
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| 11 | van der Heide A, Deliens L, Faisst K et al, "End-of-life Decision-making in Six European Countries: Descriptive Study" (2003) 326 The Lancet 345.
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| 12 | See below at . . . |
| 13 | www.wma.net/e/policy/e13b.htm
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| 14 | http://assembly.coe.int/Documents/AdoptedText/ta99/EREC1418.htm
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| 15 | http://assembly.coe.int/Documents/WorkingDocs/doc03/EDOC9898.htm
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| 16 | See Freckelton I, "Casenote: Pretty v Director of Public Prosecutions" (2002) 9 JLM 275; Leenen HJJ, "Assistance to Suicide and the European Court of Human Rights: The Pretty Case" (2002) 9 European Journal of Health Law 257.
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| 17 | Onwuteaka-Philipsen BD and van der Wal G, "A Protocol for Consultation of Another Physician in Cases of Euthanasia and Physician-assisted Suicide" (2001) 27 Journal of Medical Ethics 331.
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| 18 | Otlowski M, "The Effectiveness of Legal Control of Euthanasia: Lessons from Comparative Law" in Klijn A et al (eds), Regulating Physician-negotiated Death (Elsevier, Amsterdam, 2001) pp 137-155.
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| 19 | Kater L, "The Dutch Model for Legalising End-of-life Decisions" (2003) 22 Medicine and Law 543.
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| 20 | Griffiths J, Bood A and Weyers H, Euthanasia and Law in The Netherlands (Amsterdam University Press, Amsterdam, 1998).
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