Euthanasia in NL: What the Family Actually Sees

On April 1, 2002, the Netherlands became the first country in the world to legalise euthanasia. The law has a full name that takes thirty seconds to say — Wet toetsing levensbeëindiging op verzoek en hulp bij zelfdoding — and one clear intention: to allow a deliberate, dignified end to unbearable suffering, carried out by a doctor under strict conditions.

In 2024, 9,958 people in the Netherlands chose this path. That is 5.8% of all deaths that year.

What the law requires

A doctor may only perform euthanasia when every one of six conditions is met. There are no exceptions:

• Unbearable suffering with no prospect of improvement — ondraaglijk lijden
• A well-considered and sustained request from the patient — not an impulsive decision
• The patient is fully informed about their condition and prognosis
• There is no reasonable alternative treatment
• A second, independent doctor (the SCEN-arts) has been consulted and confirms all conditions are met
• The procedure is carried out in a medically appropriate manner

Euthanasia is not "killing." It is a deliberate decision by a terminally ill person, carried out by a doctor who has verified — twice — that there is no other way.

Who chooses it

In 2024, the breakdown by diagnosis:

What happens to the body

This is where euthanasia differs from a regular death — and where many families are unprepared.

The doctor who performed the euthanasia cannot issue the standard A-verklaring (medical death certificate). Instead, they are legally required to call the gemeentelijke lijkschouwer — the municipal forensic doctor.

The lijkschouwer records the case and notifies the RTE — the Regionale Toetsingscommissie Euthanasie, the regional review committee. The RTE examines whether all six conditions were properly met. Only after this review is completed does the family receive permission to proceed with the funeral.

The wilsverklaring — writing it down in advance

A wilsverklaring is a written advance directive — a document in which a person records their wishes in case they can no longer make decisions due to dementia or a coma. Three types matter:

• Euthanasieverklaring — a request for euthanasia under specified conditions
• Behandelverbod — refusal of certain types of treatment
• Volmacht — appointing a representative to make medical decisions on your behalf

Templates are available from the NVVE and from your huisarts. Update the document every five years, or when circumstances change significantly.

For the family: what to expect emotionally

When euthanasia is planned, the family usually knows in advance. This is different from sudden death. It gives time to say goodbye — and it creates a kind of pressure that sudden death does not.

• Anticipatory grief — grief begins before the death. This is recognised and valid.
• Relief and guilt — feeling relieved that suffering has ended, then immediately guilty about the relief. This is one of the most common experiences families describe. Relief that pain is over is an expression of love, not selfishness.
• The choice to be present or not — entirely personal. Some families want to be in the room. Others find it too much. Both are valid.

"We spent three weeks saying goodbye. In some ways, those were the most honest weeks of our family's life." — family member, Utrecht

NVVE — the organisation behind the right

The Nederlandse Vereniging voor een Vrijwillig Levenseinde (NVVE) has more than 170,000 members and has been advocating for the right to choose one's own end of life since 1973. They offer information, legal support, and help drafting a wilsverklaring.

In 2012, NVVE founded the Levenseindekliniek — now called Expertisecentrum Euthanasie — for patients whose own doctor has declined the request.

Sources: RTE Jaarverslag 2023–2024, NVVE, Rijksoverheid.nl.