"For decades, the gold standard for the coma-induction phase of euthanasia was thiopental. It was swift, reliable, and highly concentrated and rapidly induced a deep coma. In 2011, however, the European Union banned the export of drugs used for capital punishment, including thiopental. In the wake of the ban, manufacturers withdrew or tightly controlled supplies to avoid association with executions, making the drug increasingly difficult to obtain. "Thiopental is very difficult to get now," Horikx said."
"The due care criteria of the Dutch Termination of Life on Request and Assisted Suicide Act state that the physician must: Be satisfied that the patient's request is voluntary and well considered Be satisfied that the patient's suffering is unbearable, with no prospect of improvement Have informed the patient about their situation and their prognosis Have come to the conclusion, together with the patient, that there is no reasonable alternative in the patient's situation Have consulted at least one other independent physician who must see the patient and give a written opinion on whether the due care criteria set out in the previous points have been fulfilled Have exercised due medical care and attention in terminating the patient's life or assisting in their suicide"
Euthanasia involves a physician’s intentional, direct administration of a lethal substance to end a patient's life at the patient's voluntary request to relieve unbearable suffering. Assisted dying involves voluntary, self-administered ingestion of lethal drugs prescribed by a physician, with the patient performing the final act. Thiopental long served as the rapid, concentrated coma-inducing drug, but a 2011 EU export ban and subsequent manufacturer withdrawals created severe shortages. Dutch guidelines were revised as clinicians substituted propofol, an effective but imperfect alternative that requires substantially larger volumes to induce the deep coma needed for euthanasia. Physicians must meet strict due care criteria under Dutch law.
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