FIGURE 1. Number of physician-assisted deaths performed inside and outside of the Euthanasia Expertise-Centre. Dutch laws, regulations and guidelines In the Netherlands, assisting in the death of another person is currently still punishable by law. However, if physicians follow the due care criteria as described in the ‘Termination of Life on Request and Assisted Suicide Review Act’ they are exempt from prosecution. From this point on we will refer to this act as ‘the euthanasia act.’ Both assisted suicide and euthanasia fall under this act, and a practical guideline prescribes how the respective procedures should be performed. In the case of assisted suicide, the patient ingests a fluid with a heavy sedative that will suppress the respiratory stimulus and stop the heart in a matter of minutes to hours. In euthanasia, the physician intravenously administers a sedative that induces a coma, and consequently a muscle relaxant is given after which death follows almost immediately. (KNMG, 2012) The six due care criteria in the euthanasia act are the following: the physician must be convinced that the patient is making a voluntary and well-considered request [A] and that the suffering is irremediable and unbearable [B]. The patient must be educated about the situation they are in and their prospects [C]. The physician and the patient must be convinced that there is no reasonable alternative to the situation [D]. At least one other doctor must see the patient and give a written opinion on the above due diligence criteria [E]. The assisted death or euthanasia must be performed in a medically prudent manner [F]. (Regional Euthanasia Review Committess RTE: Code of Practice, 2015) When it concerns psychiatric suffering, an additional due care INTRODUCTION | 15 1