Professor William R. Winslade, Institute for the Medical Humanities, University of Texas:

Euthanasia in the Netherlands is an excellent book on an important topic. It succeeds in giving an even-handed appraisal of Dutch euthanasia practices, providing a better understanding and valuable insights of the Dutch experience with euthanasia and physician-assisted suicide. Cohen-Almagor analyses clearly and accurately the weaknesses of the policy and offers recommendations for correcting the deficiencies and developing a sounder policy. He combines an overview of the literature with analyses and interpretations of the intriguing interviews he conducted with key people in the Netherlands.

Cohen-Almagor’s book is critical but judicious. He gives a balanced account of the views with which he disagrees and he carefully explains the basis for his disagreement. His style of writing is straightforward, clear, easy to follow, logical, and coherent. Bioethicists and other scholars in medicine, public health, and law will be interested in this book. College teachers of medical ethics will also find it valuable, and educated general readers with a special interest in euthanasia will find it helpful.

Prof. Evert van Leeuwen, Faculteit der Geneeskunde, Section Philosophy and Medical Ethics, Free University of Amsterdam.

Writing a book on the Dutch experience with euthanasia is not an easy matter. Several reasons can explain the difficulty. First of all the ethics of the present palliative and terminal care has not been spelled out in detail until recent years. The difficulties every physician meets more than once in his career when confronted with a sincere wish of the patient to die in a humane way in a situation of unbearable suffering, are still puzzling for moral and legal thinking. Secondly, our ways of legal and public thinking are still not adapted to the situation in which death is a part of life, not so much as a natural fact but as a process that can be controlled. The goals of medicine to uphold human dignity and to alleviate suffering are at stake in this process. The Dutch policy to aim at a system of both legal clarity and control is perhaps at this moment the most articulated answer to the difficulties, but will almost certainly not be the last word in the issues of death and dying.

Rafi Cohen-Almagor has contributed much to the ongoing discussions by interviewing all the prominent legal, moral, political and medical people involved in the development of the Dutch legal ruling. His analysis of the interviews is based on clear, lucid thinking and argument. Unlike some others he tries to stay with the facts without entangling them with moral or political prejudice. Instead he tries to develop a view according to best standards of academic thinking. In the end he gives his own conclusion based on his experiences. One does not need to subscribe them in order to appreciate the work Prof. Cohen-Almagor has done. This book will certainly be helpful in every discussion on the legal and moral principles of assistance in dying, in traditions of legal philosophy such as the schools of Dworkin, Rawls and Kelsen. It can help physicians, nurses and others engaged in palliative care to sharpen their views in the ethics of palliative care as well in the forms of public and legal control that are needed in the burdensome but rewarding work of assistance in dying.

Int J Adolesc Med Health 2005;17(1).

Cohen-Almagor R. Euthanasia in the Netherlands. The policy and practice of mercy killing. Dordrecht, Netherlands: Kluwer Academics Publishers, 2004, 205 pages. Price: 118 USD (hard cover).

Raphael Cohen-Almagor from the University of Haifa has investigated, studied and published on the issue of euthanasia over the past many years with a special interest in the policy and practice aspects of physician assisted suicide.

This book is a case study over several years of the experience and practice from the Netherlands, where physician assisted suicide has taken place for a long period with this Dutch experience often used by other countries in their ethical and legal search for a solution to this complex problem.

The book is divided into three parts: background with research reports on the medical practice of euthanasia in the Netherlands from 1990, 1995 and 2001 and the interpretations, fieldwork by the author in the Netherlands in 1999, 2001 and 2002 and finally the conclusions.

The author has produced a well researched addition to this complex and controversial issue of mercy killing on the basis of an in-depth study of the situation in the Netherlands. The author had published and supported the performance of euthanasia before his study in the Netherlands, but his visits changed his mind and views concerning the practicality and implementation of euthanasia. The shortcomings of the Dutch experience are presented in a clear language, and in the conclusion the author provides a set of guidelines for physician assisted suicide to prevent abuse and misuse.

This book has relevance for physicians, nurses, public health professionals, lawyers, sociologists, policy makers and professionals dealing with ethics and the topic of euthanasia.

Joav Merrick, MD

Medical director, Division for Mental Retardation, Box 1260, IL-91012 Jerusalem, Israel. E-mail: jmerrick@internet-zahav.net