Sir, – It is somewhat ironic for David Tomkin (Letters, July 28th) to assert that the claim that safeguards have been removed in jurisdictions where euthanasia has been legalised is "not supported by evidence".
Here in the Netherlands over the last two decades, there has been a systematic incremental extension in the grounds for euthanasia, and a clear removal of safeguards.
These facts have been detrimental to the safety of patients at a vulnerable time in their lives.
Since the legalisation of euthanasia in 2002 for mentally competent adults, we now have child euthanasia (introduced via the Groningen Protocol in 2007), euthanasia for patients with psychiatric illnesses (88 such cases in 2020), and last year our supreme court legalised euthanasia for patients with advanced dementia.
The facts of that particular case involved a woman with dementia who had revoked her prior consent to be euthanised, and had to be restrained after she woke up during the administration of the lethal drugs.
In addition to the above, our government is currently examining proposals to permit euthanasia for children aged between one and 12.
There are now also “mobile health teams” known as “end of life clinics”, that are willing to travel to patients to administer the lethal drugs.
This practice is particularly worrying as it circumvents the safeguard of the existence of a good doctor-patient relationship before euthanasia can be administered.
No matter what your opinion is on the practice of euthanasia, it is impossible to ignore the fact that the incremental removal of safeguards has been a reality in the Netherlands. – Yours, etc,
Dr E GARCIA,
Vrije Universiteit,
Amsterdam,
The Netherlands.