Jochemsen: My reaction is mixed. The fewer cases the better. I think that the decrease to some extent is due to better palliative care. The last decade or so the availability and quality of palliative care has increased considerably. Also the fact that the percentage of reported euthanasia cases has increased from 54 % in 2001 to 80 % in 2005 is in itself positive. Which is not to say that if it is reported, euthanasia is no problem!
On the other hand, the number of cases of continuous deep sedation with a possible life shortening effect has increased with the same number as the decrease in euthanasia cases. It should be noted that sedation need not be reported and feels safer for the physician. This does not necessarily mean that there simply has been a shift from the one to the other category. To some extent the terminal sedation has been used correctly – so without a clear life shortening effect. But the impression that sedation has been used as a hidden form of euthanasia is widely shared. So a new smoke curtain has been created.
Lahl: Also, do you think it is true that 80 percent of euthanasia cases are being reported, up from the 54 six years ago and if so why do you think it’s changed?
Jochemsen: Yes, the number of cases labeled as euthanasia, that was reported has increased. But there is likely to be a certain degree of crypto euthanasia.
(Terminal sedation is essentially the addition of sedation to a dying patient. Although it is defined differently from euthanasia and appears more “natural,” it has been referred as “crypto-euthanasia.” As stated, almost 1 out of every 2 physicians who have practiced terminal sedation had, more or less, the goal of hastening death in their minds.)
Lahl: What has motivated you to become involved in field of euthanasia?
Jochemsen: The Lindeboom Institute was founded 20 years ago amongst others to resist the increasing permissiveness towards life ending actions of physicians and to further a biblically based life protecting and caring ethics. In the Netherlands this obviously meant to be involved in the euthanasia discussion. The euthanasia issue is not only relevant for patients in their last and difficult stage of life. It is about the very foundations of the state of law and of our civilization. Christians should be involved in that debate and in the activities to present the caring alternative!
Lahl: Regarding End of Life issues, what trends do you see that are encouraging and / or disturbing?
Jochemsen: Encouraging signs is the improving palliative care movement for patients at the end of life. Disturbing is that in the population there is an increasing idea that euthanasia is a right – which it is not in the Netherlands. Furthermore there is increasing pressure in the population and among certain physicians to extend the criteria for euthanasia/ PAS, for people with a beginning dementia and for people who ‘suffer of life’ without a clear medically identifiable suffering. These are symptoms of a weary culture for which ultimately only the Gospel has the answer
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