Some 25 times in his long career as a physician, Dr. Henk Maarten Laane of Amsterdam has exercised his talents not to prolong life, but to hasten death. He prefers to call it "mercy dying," not mercy killing, and he doesn't like it. But he was relieved last week when the lower house of the Dutch parliament voted overwhelmingly to legalize the practice of euthanasia. "Worldwide there are always doctors helping their patients to die," says Laane, 55. "The importance now is to show the world it can be done in a legal way, in a good way, open and controlled."
The new law, which still has to be approved by the upper house next year, sets forth rules that will make a long-tolerated Dutch practice legal. It allows a doctor to help end the life of a patient suffering unbearable pain from an incurable condition. The patient would have to request assisted suicide rather than simply concurring with a physician's suggestion, and a second examining physician would have to agree. A patient as young as 16 could request assisted suicide, and one 12 to 16 could do so with parental consent. While the law sets up a rigorous system of reporting assisted suicides, only cases of questionable procedures would be considered for legal action.
Laane has faced the bleak choice of euthanasia far more than most physicians; many of his patients are old or have AIDS. "When I help a patient to die, I know for myself that I do a good job," he says. "On the other hand, it's still unnatural to kill. The days when I do this are the most difficult. But the next day when I go back to the family, they are so relieved."
Polls show that 92% of Dutch support euthanasia, but opponents are vociferous. Dr. Pieter Hildering, chairman of the anti-euthanasia Dutch Physicians' League, says terms like "unbearable suffering" make the law highly subjective. "In the medical world, there's a large difference of opinion on what 'unbearable' is," he says. "Our great concern is that which doctor you ask will be the factor deciding whether you live or die."
Laane counters that despite government tolerance, euthanasia in the Netherlands has not increased over the past 10 years; in fact, he says, the rate among aids patients has dropped dramatically as medical treatment has improved. He also rejects complaints about subjectivity. "The only one who can say what's unbearable is the patient, I can't."
Falco Friedhoff agrees. The filmmaker was present for the scheduled death of his brother Sander, who was losing a five-year battle with AIDS. As they gathered at his apartment, family members donned T shirts that Sander had made for the occasion. As his consciousness faded, the family left the room. Then Falco returned with Laane to give Sander an injection. Recalls Falco: "There was sadness but also relief that the suffering was gone."
The process left Falco with a positive feeling about Sander's death. Another brother, Gysbert, died of AIDS three years later — in a hospital with only his mother present. "I'm unhappy because he was so alone in his struggle," says Falco, who is convinced, like most Dutch, that people should be able to cue their own inevitable exit — and that doctors can help them do it.
Reported by Lauren Comiteau/Amsterdam