The number of reported cases of euthanasia has fallen for the first time since the practice was formalised in 2002, Trouw reported on Tuesday.

There were 4,600 cases of euthanasia in the Netherlands in the first nine months of this year, a drop of 9% on the same period in 2017, Trouw said.

Jacob Kohnstamm, chairman of the regional euthanasia monitoring committee, told the paper he is surprised at the reducation. ‘Given the greying of the population, an increase was to have been expected,’ he said.

One possible explanation for the downturn is last winter’s flu epidemic, which may have led to some people who would have requested euthanasia having a natural death, the paper quoted him as saying.

However, family doctors dispute this, saying that euthanasia is usually requested by cancer patients and it is the frail elderly who are worst affected by flu.

And a spokesman for the voluntary euthanasia society told Trouw that the decision by the public prosecution department to launch five criminal investigations into euthanasia cases may have had an impact.

‘Our members are telling us that doctors are becoming more wary,’ spokesman Dick Bosscher told the paper.

Cancer

The number of people helped to die under Dutch euthanasia legislation rose 8% last year to 6,585. In almost 90% of cases, the patient was suffering from cancer, heart and artery disease or diseases of the nervous system, such as Parkinson and MS.

Three patients were in the advanced stage of dementia and 166 were in earlier stages.

Euthanasia is legal in the Netherlands under strict conditions. For example, the patient must be suffering unbearable pain and the doctor must be convinced the patient is making an informed choice. The opinion of a second doctor is also required.