Slippery slopes in flat countries - a response

In response to the paper by Keown am Fochemsen in which the latest empirica l data concerning euthanasia and other end-of-life decisions in the Netherl ands is discussed, this paper discusses three points. The use of euthanasia in cases in which palliative care was a viable altern ative may be taken as proof of a slippery slope. However, it could also be interpreted as an indication of a shift towards more autonomy-based end-of- life decisions. The cases of non-voluntary euthanasia are a serious problem in the Netherla nds and they are only rarely justifiable. However,they do not prove the exi stence of a slippery slope. Persuading the physician to bring euthanasia cases to the knowledge of the authorities is a problem of arty euthanasia policy. The Dutch notification procedure has recently been changed to reduce the underreporting of cases. However, many questions remain.