SEDUCED BY DEATH

Should the US follow the Dutch model of legalized euthanasia and physician-assisted suicide? An American psychiatrist specializing in treating the suicidal answers this question with a vehement ``No.'' A founder and executive director of the research-oriented American Suicide Foundation, Hendin (Suicide in America, 1982, etc.) examined the Dutch experience by visiting the Netherlands, studying court cases, interviewing Dutch physicans, and analyzing the historical and cultural factors that led to the country's acceptance of euthanasia and assisted suicides. He asserts that Dutch doctors conceded to him privately that euthanasia is out of control—a 1991 government report revealed that in over 1,000 cases physicians actively hastened or caused death without any request from the patient—but publicly they continue to promote it, and the Dutch courts continue to support their decisions. He concludes that a system that was ostensibly created to foster patient autonomy and self- determination has actually increased the paternalistic power of the medical profession. What we can learn from the Netherlands, says Hendin, is not to follow their lead. In the US, he argues, legalized euthanasia and assisted suicide would become a forced choice for large numbers of the poor, minorities, and the elderly. Instead, what's needed is a shift away from the medicalization of death to an acceptance of death as the inevitable end of life, better physican education in recognizing depression and in care of the dying, and better palliative care for the terminally ill. Two passages in the book are especially memorable: Hendin's bleak description of a Dutch film on euthanasia, Death on Request, which reveals medical abuses, and his account of his mother's death, which demonstrates that easy answers are hard to come by. Hendin's own arguments against euthanasia and assisted suicide are not new, but his revelations about the Dutch experience are a valuable contribution to the ongoing debate.