The number of Dutch people killed by medical euthanasia has more than doubled in the 10 years since legislation was changed to permit it, rising 13 per cent last year to 4,188 . . . One explanation for the steep rise of Dutch cases is the introduction last year of mobile euthanasia units allowing patients to be killed by voluntary lethal injection when family doctors refused.”

Is this bad news or good news?  Does the growing use of euthanasia mean the Dutch are actually becoming less happy?  Could it be the Dutch are less happy than Americans - even though - on the prestigious, European-based "Happy Planet Index" - Netherlands ranks 67th while the U.S. ranks only 105th?

Even after 10 years, I still think it's not yet possible to know the answers to these kinds of questions.  We can measure transactions and form opinions, but can those tell us whether the Dutch are doing the right thing?  I think not.  And besides, what does euthanasia have to do with happiness?

Decisions about caring for people at the end of life remain among the most significant and difficult decisions facing families today.  The Dutch model for euthanasia is a meaningful effort to help families deal with these decisions and therefore deserves the careful observation and analysis that it is receiving.

Officially the Dutch model relies on families and family physicians to reach decisions about euthanasia. That does not entirely avoid the future possibility that someday, the Dutch national health care program, or some other government's program  - say, in the U.S. - may actually prescribe euthanasia as a matter of law or regulation, in order to save money. That’s my idea of the ultimate death panel.  Brave New World indeed.

History shows that governments insist on participating in financial decisions when they are paying for the outcomes.  In other words, a government health care program cannot pretend to be a fair and impartial third-party, because it is an interested participant in the outcome. It's a conflict of interests that won't go away.

How can America avoid that possible future?  For one thing, the public cannot afford to rely on lawmakers; we must do our best to watch what other governments  - such as the Netherlands - are doing.  And for another, we must watch what our own government is doing.

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