The first five years of euthanasia legislation in Belgium and the Netherlands. Description and comparison of cases.

The Netherlands and Belgium have legalised euthanasia in 2002. In this study we describe
and compare reported cases of euthanasia and physician-assisted suicide in the first five years
of legislation. The databases of the cases reported in Belgium and the Netherlands were made
available by the review committees. We compared characteristics of all cases reported
between September 2002-December 2007. In the Netherlands, 10319 cases were reported, in
Belgium 1917. Gender and age distributions were similar in both countries. Most patients
suffered from cancer (83-87%), but patients more often suffered from diseases of the nervous
system in Belgium (8.3% vs. 3.9%).In the Netherlands, euthanasia more often occurred at
home than in Belgium (81% vs 42%) where it occurred more often in hospital (52% vs 9%).
In the Netherlands, all cases were based on the oral request of a competent patient. In
Belgium, 2.1% of the cases was based on an advance directive. We conclude that countries or
states debating legislation need to realise that the rules and procedures for euthanasia they
would agree upon are likely to influence the practice that develops once the legislation is
effected and what part of that practice is reported.