• Barend W Florijn.
• Department of Internal Medicine (Nephrology), Leiden University Medical Center, Albinusdreef 2, 2300RC, Leiden, The Netherlands. Electronic address: b.w.florijn@lumc.nl.
• Health Policy. 2018 Mar 1; 122 (3): 315-319.

AbstractThe Dutch Euthanasia Act (EA) took effect in 2002 and regulates the ending of one's life by a physician at the request of a patient who is suffering unbearably. According to the Dutch Supreme Court, unbearable suffering is a state for which the presence of a medical condition is a strict prerequisite. As a consequence, the Dutch EA has attributed the assessment of unbearable suffering to physicians who evaluate the presence of a medical classifiable disorder. Currently, a debate within the Netherlands questions whether older people, without a medical condition, who value their life as completed, should be granted euthanasia. To concede the autonomy of such a person, the Dutch government intends to create a separate legal framework that regulates this tired of living euthanasia request. This debate is crucial for policy-makers and an international audience because it discusses if a self-directed death of older people, should be implemented in (the current Dutch) euthanasia practice. However, this article argues that the current legal proposal that regulates the tired of living euthanasia request ignores crucial jurisprudence on physicians' application of the unbearable suffering criterion in practice. Furthermore it points out that this proposal neglects physicians role in guaranteeing a euthanasia practice of due care and that its use of an ethic of absolute autonomy could jeopardize this well-established practice.Copyright © 2018 Elsevier B.V. All rights reserved.

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