Dutch legalise euthanasia

Lethal injection today - suicide pill tomorrow?

The Netherlands has become the first country in the world to legalise mercy killing after a controversial law on euthanasia came into force on Monday.

The legislation allows patients experiencing unbearable suffering to request euthanasia, and doctors who carry out such a mercy killing to be free from the threat of prosecution, provided they have followed strict procedures.

The country has already tolerated the practice unofficially for decades, but parliament finally enshrined it in law last April.

The law

Patients must face a future of unbearable, interminable suffering

Request to die must be voluntary and well-considered

Doctor and patient must be convinced there is no other solution

A second medical opinion must be obtained and life must be ended in a medically appropriate way

The patient facing incapacitation may leave a written agreement to their death

Other states seem certain to follow the Dutch lead but opposition remains strong across the world.

The UN Human Rights Committee has said it is not convinced that the Dutch system can prevent abuses such as pressure being exerted on the patient.

Comparisons have also been made with Nazi Germany which put to death thousands of handicapped children and mentally ill adults, despite the fact that the Dutch law clearly stipulates that the request for euthanasia must come from the patient alone, while he or she is of sound mind.

Prime Minister Wim Kok has dismissed critics who argue that Dutch doctors now have a licence to kill. He says the idea is "bloody nonsense".

And doctors themselves say the fact that a patient is aware of the option can itself be therapeutic.

"For many terminally ill people, the fact that they can choose to die is an immense consolation," said general practitioner Coot Kuipers of the southern village of Uden.

Suicide pill

The BBC's Geraldine Coughlan in The Hague says there is already debate on widening the scope of the new law.

In one case, a group of doctors is campaigning in support of a colleague who is appealing against a murder conviction for helping a comatose patient to die without a request for euthanasia.

They doctors claim the case is not about mercy killing but medical ethics.

The Netherlands Voluntary Euthanasia Society is also debating whether elderly people should be prescribed a suicide pill to be able to end their own lives when they feel the time is right.

The doctor's role in mercy killing and the individual's right to choose to die are some of the most complex legal and ethical aspects of the emotive issue of euthanasia.

The euthanasia debate is strong in countries other than the Netherlands:

• In Belgium, senators voted in October in favour of a euthanasia bill
• In France, Health Minister Bernard Kouchner, a trained doctor, has said he will use the Dutch decision to press for legalisation
• In Australia, one region, the Northern Territory, became the first place in the world to legalise euthanasia in 1996 before the law was overturned nine months later
• In Britain, a paralysed woman recently won the right to die in a ground-breaking case.