Under the judicial doctrine of "original understanding," there is no doubt that capital punishment is constitutionally permissible. However, this does not mean that there are no prudential reasons against the use of this irreversible punishment. Regardless of the fact that guilt is determined by a jury of one's peers in an adversarial hearing, regardless of the availability of modern forensic DNA tests, and regardless of all the procedural safeguards that can take years to pay out, it is still possible that the innocent may be killed. Once a person has been executed, there is no recourse if we later decide that the sentence was incorrectly applied. Given human imperfection in making even protracted life-and-death decisions, it appears wholly irrational to go blithely along like the Netherlands believing that doctors can decide which lives are worth living and which are not. The procedural safeguards to prevent the unnecessary death of presumed criminals in the United States appear enormous compared to the feeble protections afforded the terminally ill in the Netherlands.
When euthanasia [1] became legally sanctioned in the Netherlands, the promise was that such "mercy" killings would be performed only upon a patient's thoughtfully-considered request and consent. The patient was to be completely informed about his prognosis. In addition, the physician in charge must be convinced that the patient's suffering is unbearable.
It turns out that over time, these safeguards have radically eroded, if indeed they were ever more than perfunctory. A 1991 Dutch study found that 6,000 people had been killed without explicit request or consent for euthanasia. These deaths account for about 4% of the deaths in the Netherlands [2]. Some people have requested death and had their request honored while not terminally ill, but while suffering from severe depression or suicidal inclinations. There is one known case in the Netherlands of a despondent gentleman with the HIV virus having been euthanized even before symptoms of full blown AIDS had appeared.
There is no reason to believe that the Dutch are a particularly heartless or uncompassionate people. It is just that the natural tendency of bureaucracies is to make life easy for themselves. Severely ill people are an emotional and financial burden both to doctors and their families. It is little wonder that euthanasia has extended far beyond the extraordinary cases proponents originally argued they would be limited to.
The problem is complicated by socialized medicine in the Netherlands. There are limited alternatives, especially among those with average economic means, to opt out of the choices offered by government health care. It is bad enough when one has to struggle with parsimonious medical providers to have them cover this or that condition. Imagine what could happen, if there were implicit financial incentives to hasten the permanent departure of patients.
