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Netherlands euthanasia cases fall in number causing concern that doctors simply avoid paperwork

The number of euthanasia cases reported in the Netherlands fell slightly last year.The Dutch oversight agency expresses concern that doctors were turning to terminal sedation to avoid the paperwork and hassle of a mercy killing.

The Euthanasia Review Commission's annual report said the number of registered euthanasia cases fell to 1,922, from 1,933 a year earlier, or 1.4 percent of all deaths.

In terminal sedation, patients are brought into a deep sleep while a fatal illness takes its course. It is legal or silently tolerated in most Western countries.

In euthanasia, doctors actively administer a lethal cocktail of drugs to terminally ill patients who are suffering unbearable pain and ask to die. It was legalized for the first time by the Netherlands in 2001, drawing sharp criticism from the Vatican and right-to-life groups worldwide.

Terminal sedation "is only meant for people with a very short life expectancy, of at most one or two weeks," said Reina de Valk, the commission's chairwoman, in an interview with Dutch newspaper De Volkskrant.

"It is not medically ethical to put someone with a long life expectancy to sleep and stop giving them food and drink. That is just euthanasia by other means" and should be subject to the same rules, she said.

Under Dutch law, each euthanasia case must be reported to the commission for vetting, along with evidence documenting the decision-making process. An independent doctor must agree that euthanasia is warranted before it is carried out.

The commission's conclusions were in line with a government study published last month finding terminal sedations had risen from 6 percent of all deaths in 2001 to 7 percent in 2005, while euthanasia cases including the estimated 20 percent that go unreported fell from 2.5 percent to 1.7 percent.

Data on terminal sedation and euthanasia are hard to find for other Western nations. In the United States, palliative care has been ruled constitutional by the Supreme Court, but doctors are mostly unwilling to discuss it in public.

"The increased interest for palliative sedation doesn't mean that the demand for euthanasia will disappear," the commission's report said. "Unbearable suffering can't always be relieved by sedation."

The Netherlands' center-right government, which is dominated by two Christian-values parties, has not yet reacted to the April report. But it pledged not to make any substantial changes to the policy, which enjoys widespread public support, after taking office in February.

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