The Hague - The upper house of the Dutch parliament approved a euthanasia bill on Tuesday, clearing the final hurdle for a law that makes this the first country to let doctors end the lives of patients who suffer unbearably and without hope.
The vote, which endorsed a vote by the lower house last November, was 46-28 with one person absent.
"I hereby declare the proposal adopted," said chairperson Frits Korthals Altes, after two days of debate.
Before the vote, health minister Els Borst gave a final assurance that the law could not be abused by doctors because of the careful supervisory provisions.
"I am convinced they will carefully balance the considerations," she said.
Even though the vote was seen as a formality, an estimated 10 000 people gathered outside in one last show of discontent.
Many sang hymns and quoted the Bible, then marched silently past the building where the senate debated the proposal.
The bill is likely to take effect this summer.
The law formalises a practice discreetly used in Dutch hospitals and homes for decades, turning guidelines adopted by parliament in 1993 into legally binding requirements.
Those guidelines presuppose a long doctor-patient relationship, and exclude the possibility of euthanasia for nonresidents of the Netherlands.
Outside the parliament building, some protesters stood masked in black balaclavas and carried oversized syringes dripping with blood-red liquid.
Others gathered signatures for a petition that already had 25 000 names before the debate opened on Monday evening.
In the weeks preceding the debate, the upper house was swamped with an unusual amount of mail - about 60 000 pieces urging that the bill be killed.
Despite the strong showing of opponents on Tuesday, they are a small minority in the Netherlands, once a stronghold of Christian politics.
In the debate, Health Minister Borst said a broad consensus had coalesced after 30 years of discussion. Nearly 90 percent of the population backed the proposed changes, she said.
Under the law, a patient would have to be suffering irremediable and unbearable suffering, be aware of all other medical options and have sought a second professional opinion.
The request would have to be made voluntarily, persistently and independently while the patient was of sound mind.
Doctors are not supposed to suggest it as an option.
The new law also would allow patients to leave a written request for euthanasia, giving doctors the right to use their discretion when patients became too physically or mentally ill to decide for themselves.
An independent commission would review cases to ensure the guidelines were followed.
If a doctor were suspected of wrongdoing, the case would be referred to public prosecutors for review and possible punishment.
Several countries - Switzerland, Colombia and Belgium - tolerate euthanasia. In the United States, Oregon has allowed doctor-assisted suicide for the terminally ill since 1996, but its law is more restrictive than the Dutch bill.
In Australia, the Northern Territories enacted a law in 1996, but it was revoked in 1997 by the federal parliament.
The drafters of the Dutch bill denounced a plan by Australia's leading euthanasia campaigner to set up a floating clinic in a ship flying the Dutch flag off the coast.
Dr Philip Nitschke had said if the Dutch legalise euthanasia, he would offer clients lethal injections in international waters off the Australian coast.
Borst said the Dutch government would do "whatever it could" to counter any such effort and stressed that the scheme "could by no means" fit into the Dutch rules. - Sapa-AP