Euthanasia still a dilemma for Dutch doctors

By Emma Thomasson

AMSTERDAM (Reuters) - "I am not a monster. I'm also not a God. In the best case I'm an angel," muses a doctor in a Dutch play about euthanasia, before delivering a lethal injection to an old friend, a cancer patient.

"The Good Death" is playing to packed houses across the Netherlands, which became the first country to legalize euthanasia in 2002 despite condemnation by the Roman Catholic Church.

The play reflects the fact that far from becoming standard practice after legalization, euthanasia -- Greek for "good death" -- remains an agonizing decision for all involved.

Official figures actually show a fall in euthanasia cases in recent years and a rise in the use of sedation for the terminally ill.

Dutch campaigners say some doctors are shying away from making a decision about euthanasia and they want the law relaxed further to make mercy killing easier.

While euthanasia is also legal in Luxembourg and Belgium and is permitted in Switzerland if performed by a non-doctor, activists elsewhere in Europe are fighting for decriminalization.

The case of Chantal Sebire, a woman with a face-distorting tumor who was refused assisted suicide, rekindled the debate in France. Sebire was found dead of an overdose at home in March days after a court rejected her bid for medical help to die.

The mercy killing of Belgian writer Hugo Claus, who suffered from Alzheimer's disease but was well enough to express his wish for euthanasia, has also exposed divisions in Belgium between supporters and opponents of legalization.

"The Good Death" follows the last day in the life of fictional lung cancer sufferer Bernhard Keller as his dysfunctional family gathers to bid farewell, deftly mixing black humor with emotional drama and philosophical reflection.

"A lot of people who come who have had to deal with euthanasia do not find much comfort in laws or politics, but they do find it in such a play," said director Wannie de Wijn.

"What interested me is how come people don't go crazy if they know that their nearest and dearest won't be there in 24 hours," he said, adding he was inspired to write the play after a friend's father died by euthanasia.

SEDATION VS EUTHANASIA

The number of Dutch euthanasia cases fell to 2,325, or 1.7 percent of all deaths in 2005, from 2.6 percent in 2001. Though it only became legal in 2002, euthanasia has long been an accepted practice in the Netherlands and doctors avoided prosecution if they met certain conditions.

Those conditions were formalized in legislation: patients must face a future of "unbearable suffering" and make a voluntary, well-considered request to die. Another physician must be consulted and an expert panel examines each case.

The Dutch Health Ministry says the fall in euthanasia cases is partly due to improvements in care for the dying and a rise in the number of terminally ill patients who are given sedatives to render them unconscious until death.