The Netherlands has become the first country in the world to legalise euthanasia after the upper house of parliament voted yesterday, as expected, in favour of the highly controversial measure.
The new law means that doctors who help patients to die under strict conditions will be immune from prosecution. Until now technically they faced up to 12 years' imprisonment if it was found they had strayed from existing guidelines.
Legislation also recognises for the first time the validity of written requests to die. Patients allowed euthanasia must face continuous suffering and make a voluntary and lasting request. Doctors must have informed patients about their prospects and reached the conclusion there is no reasonable alternative. All cases will automatically be referred to the coroner and a review committee comprising a doctor, an ethics specialist and a lawyer.
The lower house of the Dutch parliament voted by a large majority last year to legalise euthanasia, and the approval of the upper house was seen as a formality.
The debate was a surprisingly heated one, however, with the Christian Democrats (CDA) and the small Calvinist parties vehemently opposing the bill. The CDA does not object to euthanasia but argued that legalising the practice would make it "an everyday occurrence".
The liberal left Green Party joined the CDA in voicing concern that doctors and nurses who were against mercy killing could find themselves pressurised to assist in cases. The law stipulates that doctors against euthanasia are obliged to refer a patient who has requested it to another practitioner.
The issue of euthanasia has been keenly debated in Holland since the 1970s when doctors first started carrying out mercy killings. Figures show that Dutch doctors helped 2,216 patients to commit assisted suicide in 1999, the physicians supplying the drugs but not administering them. Some countries have refused to see the Dutch policy as anything less than the first step down the road to Nazi-style genetic selection. Mindful of this, the Justice Ministry has stressed that doctors who do not meet stringent conditions set out in the new legislation will face the full rigours of the law.
There is nothing in the new legislation suggesting that non-Dutch citizens or those without residence status in the country are ineligible for euthanasia.
However, strict requirements in place make it "virtually impossible" for anyone who has not had "a long confidential relationship with their doctor in Holland" to seek euthanasia in the Netherlands.
Thousands of letters and emails were received from Britain, France, Belgium, the US and Australia urging Dutch parliamentarians to approve the bill. This was due to the belief that the Dutch initiative would encourage debate in other countries, according to Dr Jacob Kohnstamm, president of the Dutch Voluntary Euthanasia Society and a member of the Dutch upper house.
The only other legislatures with laws close to the Netherlands policy are in the US state of Oregon and in Australia's Northern Territory. Oregon allows physician-assisted suicide while the Northern Territory legalised medically assisted suicide in 1996, but that law was later repealed.