The Hague -- Euthanasia in The Netherlands is "beyond effective control", according to a report which shows that one in five assisted suicides is without explicit consent.
British opponents of assisted suicide say that the figures are a warning of the dangers of decriminalising euthanasia, as Holland did in 1984. By 1995 cases of euthanasia and assisted suicide in Holland had risen to almost 3 per cent of all deaths.
The Dutch survey, reviewed in the Journal of Medical Ethics, looked at the figures for 1995 and found that as well as 3,600 authorized cases there were 900 others in which doctors had acted without explicit consent. A follow-up survey found that the main reason for not consulting patients was that they had dementia or were otherwise not competent.
But in 15 percent of cases the doctors avoided any discussion because they thought they were acting in the patient's best interests.
Michael Howitt Wilson, of the Alert campaign against euthanasia, said: "A lot of people in Holland are frightened to go into hospital because of this situation."
Dr Henk Jochensen, of the Lindeboom Institute, and Dr John Keown, of Queens' College, Cambridge carried out the study. They conclude: "The reality is that a clear majority of cases of euthanasia, both with and without request, go unreported and unchecked. Dutch claims of effective regulation ring hollow."
Another study appearing in the journal shows that the legal assessments of cases reported to the public prosecution service in the Netherlands vary considerably. Cases are reported to determine whether a doctor will be prosecuted for murder. The study was carried out by Dr Jacqueline Cuperus-Bosma, of Vrije University in the Netherlands. The paper concluded that there is a need for clear protocols.
Dr Peggy Norris, chairwoman of the anti-euthanasia group Alert, said: "We need to learn from the Dutch system that euthanasia cannot be controlled."
"I know of patients in a nursing home who are carrying around what they call sanctuary certificates all the time, stating that they do not want to be helped to die. People are afraid of being sick or of being knocked down in case a doctor takes the decision, without their permission, to stop treatment."
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