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In 30 years, the Netherlands has moved from euthanasia for the terminally ill, to euthanasia for those who are chronically ill; from euthanasia for physical illness, to euthanasia for mental illness; from euthanasia for mental illness, to euthanasia for psychological discomfort or mental suffering - and now to euthanasia simply if a person is over 70 and "tired of living." Dutch euthanasia protocols have also moved from conscious patients, rendering euthanasia with explicit consent, to subconscious patients who are unable to consent. Denial of euthanasia or assisted suicide in the Netherlands is now considered a form of discrimination against people with chronic illnesses, whether the illness may be physical or psychological, because these people will be forced to "suffer" more than those who are terminally ill. Involuntary euthanasia is now a justified way to appeal to the public duty of citizens and ethical positions of mercy. In the Netherlands, euthanasia has evolved from being a last resort to being one of the early manifestations of medical intervention.