The woman Dr. van Oijen was killing was not prepared to go gently. His patient for seventeen years, the 84-year-old woman had endured bone disease, heart and vascular problems, and skin infections across her body. Despite her physical misery, she was a defiant survivalist: though she suffered in one of the world’s most euthanasia-friendly countries, the Dutch patient told her family that she did not want to die and never requested to end her life. Her daughter, however, found such declarations unconvincing, begging to Van Oijen, “Do something. Would you leave your dog like this?” Without seeking a second medical opinion, Van Oijen obliged one day in February of 1997, administering 50 mg of the muscle relaxant alloferine to his patient. She died shortly thereafter. Religious groups condemned Van Oijen’s actions as homicidal, but their protests were largely ignored: in 2001, an Amsterdam court ruled that Van Oijen had acted “honorably and according to conscience,” penalizing the doctor with only one week in prison. Today, Van Oijen continues to practice.

This is the face of euthanasia in the Netherlands: a mainstream procedure staunchly defended by general practitioners and vigorously denounced by religious activists. Since a 1974 court ruled “terminal illness, voluntary consent and unbearable suffering” to be sufficient grounds for euthanasia, the Dutch government has steadily loosened restrictions on the practice. In 2001, the Netherlands became the first nation to totally legalize euthanasia; this year, an inquiry by the Royal Dutch Medical association expanded the scope of the law, affirming the right of assisted suicide for those who are “suffering through living”—a cryptic standard that could encompass patients who are not actually ill. Perhaps most startlingly, the Dutch parliament convened in November to debate a new amendment, referred to as the “Groningen Protocol,” which would allow doctors to euthanize terminally ill or suffering newborn children.