Basic concepts

Euthanasia
In the Netherlands euthanasia is usually understood to mean ending the life of another person at their express request. This is also the definition used in article 293 of the Dutch Criminal Code.

Assisted suicide
Assisted suicide is taken to mean providing another person with the means to commit suicide. Under the provisions of the Criminal Code suicide is not an offence, but assisted suicide is (article 294).
Since the entry into force of the Termination of Life on Request and Assisted Suicide (Review Procedures) Act on 1 April 2002 special grounds for immunity from criminal liability have been included in both these articles of the Criminal Code. This means that termination of life or assisted suicide are not offences if performed by a doctor who complies with the due care criteria set out in section 2 of the Act and reports his actions to the municipal pathologist.

Palliative sedation
The deliberate lowering of a patient’s level of consciousness in the last stages of life.

Other medical decisions at the end of life
Euthanasia and physician-assisted suicide should be distinguished from other end-of-life decisions which are part of normal medical practice, such as in the case of:

• refusal of treatment: a patient who is mentally competent may refuse his or her consent for the start or continuation of medical treatment. The doctor in question must respect that decision, even if it results in or speeds up the patient’s death.
• withholding or withdrawing medically futile treatment: this requires a medical opinion on whether further treatment has any point. In such situations, the doctor should consult with colleagues to ensure that the decision is as objective as possible.