Italian
There is a common thread running through the debate on euthanasia that, like it or not, we can no longer ignore: the gap between the written law and actual practice. The figures from the Netherlands are not cold statistics: they are alarm bells ringing in unison. In just one year, 517 people were killed without ever having asked to die
NETHERLANDS. In 2021, 9,799 people died in the Netherlands as a result of end-of-life medical decisions: 9,038 by euthanasia, 245 by assisted suicide and 517 without any explicit request. Among the latter, six were newborns. Twenty-two per cent of all cases were never officially recorded.
When the Netherlands legalised euthanasia in 2002, the promise was clear: only in extreme cases, only with explicit consent, only when suffering was unbearable and without remedy. Today, the numbers tell a different story. The five-year study commissioned by the Dutch government — based on anonymous questionnaires to doctors — recorded a total of 9,799 medically assisted deaths in 2021, of which 517 (5.3%) were without any request from the patient.
This figure conceals situations that would once have been inconceivable: 206 euthanasia cases for people with early-stage dementia, 6 with advanced dementia and 115 patients with severe psychiatric disorders. Among the 517 cases without consent, six infanticides were probably carried out according to the Groningen Protocol, which allows the killing of newborns with disabilities when doctors and parents consider their lives “incompatible with dignity”.
The official Dutch report for 2021 records 7,666 reported cases of euthanasia. The independent study, however, finds 9,799 cases: 2,133 more than the official figures, equivalent to an under-reporting of 22%. This is not an isolated anomaly: already in 2015, compared to 5,561 reported cases, an independent analysis identified 7,254, with 1,693 “phantom deaths” — 23% more.
This consistent discrepancy between official and actual data reveals that this is not a matter of administrative oversight, but a structural problem: a system that, despite its label of “transparency”, conceals a significant proportion of medically induced deaths.
Canada introduced Medical Assistance in Dying (MAiD) in 2016. In Quebec, in the two-year period 2021-2022, the official commission recorded 3,663 deaths, but a cross-analysis with data from healthcare facilities and the Collège des Médecins du Québec found 3,952: 289 more.
In the United States, Oregon — a pioneer in assisted suicide — counted 376 recorded cases in 2024, but in 178 of these cases it is not known whether the drug was ingested or whether the patient actually died from that cause. These gaps in information pave the way for undetectable abuse.
Behind these figures lies a profound change: the idea that life is a right only if it is “of quality” and that, when it is not, it can be “corrected” with a definitive act. It is a subtle but devastating cultural shift: from an unconditional good to a conditional good. A shift that removes responsibility from society and entrusts medicine with a power that should never belong to anyone: to decree, without request, the end of a life.
It is a dangerous mistake to delude ourselves that this spiral cannot affect other countries, including Italy. The history of “progressive” legislation is littered with good intentions that have turned into irreversible drifts. The question, at this point, is no longer “if” it can happen, but “when” and “to whom”.
The legalisation of euthanasia is not a safe and well-defined finish line: it is a slippery slope. Once you set foot on it, it becomes almost impossible to stop.
Those who think that “it will never happen here” forget that the history of “progressive” laws is a history of shifting boundaries. It starts with extreme cases and, over time, the net widens. The Netherlands is a social laboratory that shows us a possible future: deaths without consent, including infants, covered-up data and ineffective controls.
Legalised euthanasia is not the end of the line, but the beginning of a slippery slope. Once you start down it, turning back is almost impossible.
That the life of a newborn baby can be judged “incompatible with dignity” is a phrase that, if it were not written in a medical protocol, would seem like a moral paradox. The Groningen Protocol, applied in the Netherlands, stipulates that if doctors and parents agree that the child’s suffering is “unbearable and without prospect of improvement”, lethal injection may be administered.
Here we touch on an anthropological threshold: a newborn cannot express consent, cannot manifest will, cannot even understand its own condition. It is the human subject in its purest form, devoid of any functional capacity, yet fully entitled to exist. To replace this absent voice means placing oneself in a position of absolute power: no longer caring, but selecting.
The philosopher Emmanuel Levinas spoke of the “face of the Other” as the primary, irreducible ethical call that obliges us to respond with care, not with elimination. Suppressing a disabled newborn means not recognising the face as a face, but reducing it to a “clinical case” to be resolved. It is the transition from relationship to management, from ethics to technique.
Every time we introduce the possibility of “deciding for another” on the basis of the perceived quality of their life, we open a breach that can never be closed. The culture of death, by its very nature, is not confined to “exceptional cases”: its scope grows silently but inexorably.
Ultimately, the question is this: is life an unconditional good or a conditional good?
If it is unconditional, no suffering, however atrocious, authorises another human being to decree its end. If it is conditional, then everything becomes negotiable: age, health, ability, consciousness, expressed or presumed desire.
St John Paul II, in Evangelium Vitae, wrote: “The criterion of dignity cannot be measured on the basis of functionality or productivity, but on the simple fact of being a human person.” If we lose this certainty, we will not know where we will stop.
