Voluntary euthanasia and the risks of abuse: can we learn anything from the Netherlands?

In the United Stares' quite volatile public debates over the legalization of voluntary active euthanasia and physician assisted suicide, much has been made of the risk of abuse. Indeed, it was probably tears of abuse that contributed more than any other single factor to the 1991 defeat of the United States' first ballot test of legalizing euthanasia, the state of Washington's Initiative 119, despite prior state and national polls suggesting the measure would pass. Opponents of Initiative 119 , which would have legalized physician-performed euthanasia or physician-provided aid in suicide when voluntarily requested by competent terminally ill patients with less than six months to live, variously claimed that the legislation would encourage greedy family members to pressure patients into choosing death, that unscrupulous physicians would kill patients who became unattractive to treat, that cost-cutting pressures from hospitals, insurers, and other institutions would force patients into death, and that race-, age-, and handicap-prejudice would take an especial toll among vulnerable groups.