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Substance X furor rekindles Dutch debate on loosening euthanasia rules

ZWOLLE, Netherlands (Reuters) - When a Dutch right-to-die group said in February it would make good on its promise to help members buy a cheap and painless suicide powder dubbed “Substance X”, 81-year-old Carla Jas, who joined the group in 2013, celebrated the news.

Jas had always set her own course in life, breaking from her religious family, raising four children alone and traveling across Australia for a year.

When it came to her death, Jas wanted the same level of independence, to opt out of a slow descent into dementia or a drawn-out decline in a sickbed.

Cooperative Last Will scrapped its plan for Substance X after prosecutors launched an investigation into the group following the suicide of a 19-year-old woman. Her parents blamed Last Will on the grounds that its announcement made her aware of the existence of the chemicals she used to kill herself.

Last Will denied any responsibility in the teenager’s death. Prosecutors determined there was no direct link and said no charges would be brought.

But the furor rekindled a long-running debate over whether to review the rules on euthanasia in the Netherlands, the first country to legalize the practice. It’s an issue that is being closely watched by the handful of other countries and U.S. states that allow euthanasia or assisted suicide.

Jas, who is not currently ill, is afraid that under the stringent laws now in effect she will not be able to seek assisted suicide when she feels her time has come, and will end up suffering.

“I’ve seen that (suffering) too much around me,” she said in her apartment on the outskirts of Zwolle, a 1,200-year-old town in the north of the Netherlands. “I find it so humiliating.”

Last Will was founded in 2013 by members who broke away from established right-to-die group NVVE.

In the burst of publicity over Substance X, membership has soared from 3,000 last year to more than 23,000 now, the group said. More than 520 people joined in a single day on March 22.

“For my generation, the generation of the baby boomers, self-determination is key,” said Last Will board member Petra de Jong, a former pneumologist turned euthanasia campaigner. “The membership applications are streaming in.”

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De Jong called the interest a show of public support for efforts to loosen the criteria around euthanasia to make it easier for elderly people who are not terminally ill to legally end their life.

Opponents say such a step could be dangerous for a sector of society that is particularly open to abuse.

“In practice this will mostly consist of a vulnerable group, who experience a loss of purpose and are dependent on others to help them,” the Royal Dutch Medical Association said on its website. “This is a complex and tragic issue for which there are no simple solutions.”


The Netherlands placed demanding conditions on euthanasia and physician-assisted suicide when it was legalized in 2002.

Patients have to be experiencing unbearable physical or mental suffering, with no prospect for improvement, and have to have asked repeatedly to die. Qualified medical doctors decide whether those criteria have been met.

A second opinion must be sought and the process reviewed by an independent panel, which has the power to refer cases to the authorities and to reprimand or refer doctors if necessary.

The current law thus clearly distinguishes what happens in the Netherlands from assisted suicide, legal experts said.

“A person who intentionally helps another with suicide or provides the means” faces a prison sentence of three years or a fine, said prosecution spokeswoman Mary Hallebeek.

“The only exception is if you are a doctor and you adhere to the strict criteria laid down in the euthanasia law.”

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No doctor has been prosecuted since the law was passed.

What’s happening now is that the discussion in countries where euthanasia is legal is shifting to whether ending life is a medical issue or a human rights one, said Philip Nitschke, the Australian founder of pro-euthanasia group Exit International.

“The rights model is gaining currency and it’s played out in the Netherlands more than anywhere else because of this long experience with the medical model,” he told Reuters.

The number of euthanasia cases in the Netherlands rises every year. The 6,585 cases in 2017 accounted for 4.4 percent of deaths and was up 4 percent from 2016, according to RTE, an umbrella organization of regional review bodies.

Polls in the Netherlands indicate there may be support for an expansion of the practice. A 2016 poll by RTL news and DVJ Insights showed 77 percent of 1,000 people polled supported allowing elderly people who believe “their life is complete” to request a legal and humane way to die.


Last Will’s plan was to put members together with a “buyer” who would distribute Substance X, which it declined to name but described as a legally available chemical used as a preservative for meat and a laboratory cleaner to kill moulds and bacteria.

Members needed to buy a special fingerprint-activated safety deposit box to store the substance safely, it said.

Last Will does not now plan to facilitate the distribution of the powder or reveal its chemical composition after prosecutors said doing so could result in lawsuits.

A change in the law is unlikely to happen under the current Dutch government, a coalition that includes the socially conservative Christian Union party.

Carla Dik-Faber, a Christian Union member of parliament, said loosening the criteria would be a recipe for disaster.

“A legal possibility suddenly becomes a real option and people will start asking if they should take such a substance. It can be abused, get into the wrong hands,” she said. “People could feel pressured by the people around them.”

Rather than making it easier to commit suicide, lawmakers should focus on improving the lives of the elderly, many of whom are lonely or depressed, the Dutch medical association said.

Carla Jas said she is too busy to think about ending her life now, but added she does not intend to wait for the outcome of a political debate.

Surrounded by mementos of her Australia travels, she showed a Reuters reporter a small silver packet which she said contained an illegal poisonous substance ordered on the web from China four years ago.

“It is a weight off my back” to know it is there, she said. “I have been happier ever since, which is nice and means I will live longer. Which is what everybody wants.”

Editing by Anthony Deutsch and Sonya Hepinstall