For several years the KNMG has been examining pain and suffering as necessary conditions for legitimate requests for euthanasia and assisted suicide and has accepted the notion that mental suffering may be unbearable even when the patient has no physical disorder but rather suffers solely from psychosocial causes.
Moreover, the almost symbiotic relationship between the KNMG and the courts is rather unusual and makes one wonder what effect it has on public participation in the discussion.
He could have pointed out that falsely entering death by natural causes was condemned in the 1984 KNMG report as an improper practice that should be discontinued,(6) that it was confirmed by the court of appeal in 1987 to be a criminal offense.
Moreover, he concedes that most fall within the "broadest limits" stipulated by the KNMG (p.
Although the KNMG guidelines state that the request must be entirely voluntary.
Further, the results of a survey of general practitioners by the medical examiner Gerrit van der Wal that appeared in the KNMG journal in February 1991 do little to allay concern over variable interpretation and application of the criteria.
Fourth, as concern for the protection of the incompetent features largely in Gomez's critique, he could have mentioned that the State Commission on Euthanasia, which reported in 1985, recommended that the termination of incompetent patients be legalized, provided they had irreversibly lost consciousness and treatment had been suspended as pointless, and that the KNMG discussion paper on handicapped neonates condoned their termination.
Is there not, as a spokesman for the KNMG put it to me, a choice between, on the one hand, prohibiting euthanasia and not knowing how often it is carried out and, on the other, legalizing it and knowing how most of it is carried out?
3)The Central Committee of the Royal Dutch Medical Association, Vision on Euthanasia (Utrecht: KNMG
, 1986); Netherlands State Commission on Euthanasia, "An English Summary," Biothics 1 (1987), 163-74; Committee of the Health Council of The Netherlands, "Conditions of Euthanasia" (in Dutch) (The Hague: Gezondheidsraad, 1987); H.