Euthanasia

Palinurus

The Living Force
I think we should always keep in mind we're talking about death on request in practically all cases mentioned here -- either from the patients themselves or, in the case of critically ill newborns, their parents.

I admit there's a gray area developing that seems to be growing but this thread gives a magnified view on those developments because we are focusing our attention not only on the normal practice but also on the fringe cases as those get the most media coverage. This may skew our opinion a bit. FWIW.
 

Nienna

SuperModerator
Moderator
FOTCM Member
I understand what you are saying, Palinurus, and what better way to get rid of those who you don't find good enough than to make it their choice to be euthanized? And I do understand completely why some people would want to end their lives when they are in such deep pain or confusion such as dementia (heck, I could, at some time in the future, want the same thing); but still, these are just the sorts of people, young and old, that those in control have been saying for quite some time that should have been done away with. I'm not judging those who are in distress and don't feel they can handle it anymore, but those who have been wanting this sort of thing for quite some time.
 

Palinurus

The Living Force
Source (Dutch only): Waarschuwing voor arts na euthanasie op demente vrouw

DeepL Translator said:
NOS News - Interior - Today, 13:23

Warning for doctor after euthanasia on demented woman

The Regional Health Care Disciplinary Board has issued a warning to a geriatrics specialist due to an untidy euthanasia. The board ruled that the doctor from the Amsterdam region did not sufficiently substantiate why she deviated from the advice of the SCEN-doctor [in Dutch] [SCEN = Support and Consultation for Euthanasia in the Netherlands], who, as an independent doctor, gave a negative opinion on the euthanasia request.


In May 2017, the doctor put an end to the life of a 67-year-old woman, who was severely demented. When she had been diagnosed with Alzheimer's years before, she registered in a declaration of intent that she absolutely did not want to be admitted to a nursing home. If it did come to that, she wanted to die. Nevertheless, she was admitted in 2013.

The woman's GP began the euthanasia procedure in 2017, after persistent requests from the family. In the end, the family doctor did not want to do it himself and called in the geriatrics specialist, who took over the process.

SCEN doctor: no unbearable suffering

After extensive research she became convinced of the correctness of euthanasia and called in the compulsory SCEN-doctor. But this doctor ruled that there was no unbearable suffering and that the euthanasia could not continue.

After consultation with her colleagues, the geriatric specialist asked another doctor, from the Stichting Levenseindekliniek (now Expertise Center Euthanasia), for an opinion. That doctor was indeed convinced that all due care requirements had been met and that euthanasia could therefore be performed.

According to the disciplinary board [in Dutch], the doctor made a mistake. She should have urged the SCEN-doctor to give a different advice or she should have asked for a second SCEN-doctor. The disciplinary board does not regard the 'Levenseinde-doctor' as independent. "Nor can his statement serve as an alternative to the SCEN-advice and, moreover, cannot be regarded as an unambiguous confirmation of the hopeless and unbearable suffering."

The doctor had already performed euthanasia about seventy times, but never on an incapacitated patient yet. According to the College, the fact that there is much debate about this issue both inland and abroad plus that this case was exceptional for her, "should have led to even greater procedural meticulousness than is already customary."

Euthanasia was allowed

The college also considered whether euthanasia could be performed, although the patient could no longer ask for it verbally. The doctor was proved right. The Board is of the opinion that this was a voluntary and well-considered request and that the doctor was entitled to substitute the 2011 declaration of will for an oral request for euthanasia.

In April, the Supreme Court, the highest court in the Netherlands, ruled [in Dutch] that a doctor may comply with a written request for euthanasia from someone who is no longer able to express his/her will unambiguously due to advanced dementia.


Translated with www.DeepL.com/Translator (free version)
 

Palinurus

The Living Force
Source (Dutch only): Fransman die geen euthanasie mag krijgen, mag ook zijn dood niet livestreamen op Facebook

DeepL Translator said:
NEWS Euthanasia policy France

Frenchman who is not allowed to get euthanasia, is also not allowed to stream his death live on Facebook

Even President Macron sympathizes with him, but the law is the law he says, and French law prohibits euthanasia. That means no doctor can help Alain Cocq die, but even the live streaming of his slow, protracted death on Facebook is not allowed - Facebook blocks live streams of 'suicide'. Cocq's death will become a statement of powerlessness.

Daan Kool - September 6, 2020, 18:52


Alain Cocq is lying in bed in his apartment in Dijon. Image AFP


The incurably ill Alain Cocq (57) calls it his 'final battle'. After his euthanasia request was rejected, he decided not only to stop taking food, fluids and medication, but also to stream his dying process live on Facebook. 'You can't die with dignity in France,' says Cocq, who wanted his action to spark a debate about France's strict euthanasia policy.

However, he had counted outside the rules of Facebook. The social medium is 'deeply affected by the difficult situation Alain Cocq is going through', said a spokesperson in Le Monde, but it nevertheless decided to block the live stream because the company's house rules do not allow 'suicide attempts' to be shared. On his Facebook page, Cocq is calling on his 23 thousand followers to protest against this decision.

Cocq has been suffering from a rare, incurable disease in his veins for 34 years. That did not stop him from living a militant life. In the nineties he rode a 'Tour de France' in his wheelchair to draw attention to the position of disabled people. But Cocq's health deteriorated noticeably in a short period of time. Since two years he is confined to bed and dependent on tube feeding. He has suffered five heart attacks and seven strokes in recent years, and is increasingly losing his hearing and sight. 'I'm just lying there staring at the ceiling. No, this is not a life,' he said to the French public broadcaster.

'Candy'

At the end of July Cocq wrote a letter to President Macron, asking for 'the right to a dignified death, with active medical assistance'. Cocq asked Macron to make an exception to the strict French euthanasia law by allowing his doctors to give him a lethal dose of sleeping pills. In a video on his Facebook page he talked about his 'candy'. He wanted to 'finally fall asleep', 'find relief from the pain that has been torturing me for 34 years'.

The president wrote back to be emotionalized and to respect Cocq's plan. But Macron cannot 'ask anyone to violate our current legal frameworks'. 'I am not above the law and I am not able to grant your request'.

Although about 90 percent of French people are in favor of euthanasia, active medical termination of life is not allowed in France. Only if there is 'an advanced and terminal stage of a serious and incurable condition' - in other words, if a patient has only a few days or hours to live - may physicians prescribe painkillers that 'as a secondary effect, shorten life'. Patients such as Cocq, who do not want to wait for the agony that precedes those last days, are excluded.

Symbol

Cocq is not the first terminally ill Frenchman who has become a symbol of the fight against the strict euthanasia policy. In 2002, Vincent Humbert, paralyzed, blind and deaf following a motorcycle accident, asked President Chirac for euthanasia. The request was rejected. Humbert's mother eventually administered him a lethal dose of sleeping pills. A criminal investigation was opened against her; the case was discontinued. In 2008, Chantal Sébire, who had a tumor in her face, asked in vain for medical termination of life to then President Sarkozy. She also died later that year of a high dose of sleeping pills.

There are hardly countries where, on paper, religion and politics are so strongly separated as in France. But in practice, French society is firmly based on Catholic principles. This is reflected in medical-ethical issues such as the euthanasia debate - but also, for example, in gay marriage. When this was introduced in 2013, more than 300 thousand opponents demonstrated in Paris.

Cocq stressed in the French media that he himself is a Catholic and that his euthanasia request is not at odds with that. 'God is love. He would not let his people suffer unnecessarily'. In the night from Friday to Saturday Cocq had his final meal. He expects to die within a few days. 'The road to deliverance begins,' he said in a video, 'and believe me, I am happy'.


Translated with www.DeepL.com/Translator (free version)
 

Palinurus

The Living Force
UPDATE (Dutch only): Ernstig zieke Fransman die dood wilde streamen ziet af van plan

DeepL Translator said:
Seriously ill Frenchman who wanted to stream death renounces plan

1 hour ago in FOREIGN

PARIS - An incurably ill Frenchman who had stopped eating and would broadcast live images of his death, renounces his plan. "I don't have it in me to fight any more," Alain Cocq said from the hospital in Dijon.

The 57-year-old Cocq has been suffering from a degenerative disorder for decades and had asked for active euthanasia, but that request was rejected. He therefore refused to eat and drink since Saturday. The Frenchman announced Wednesday that he has been fed again and that he will be able to go home soon.

Active euthanasia is not allowed in France. Cocq had therefore asked President Emmanuel Macron for help, but he said he could do nothing for him. Facebook also refused to cooperate with Cocq's plan, who wanted to broadcast images of his death via that platform. A company spokesperson said that the rules do not allow the display of attempted suicides.

The euthanasia debate is very sensitive in France too. This led to a lengthy legal joust about the fate of Vincent Lambert, who was in a vegetative state in a nursing home for years after an accident. His case divided France and Lambert's family. His treatment was finally stopped, after which he died last year.


Translated with www.DeepL.com/Translator (free version)
 

Palinurus

The Living Force
Source: Euthanasia figures expected to double in eight years, says head of centre - DutchNews.nl

Euthanasia figures expected to double in eight years, says head of center

September 11, 2020 - By Senay Boztas

Twice as many people will probably be granted euthanasia eight years from now, according to the outgoing head of a center specialized in complicated requests.

Steven Pleiter, chairman of the Expertisecentrum Euthanasie (formerly the End-of-life clinic) in The Hague told Trouw [in Dutch] that given the increase in older people, he expects annual euthanasia cases to double to some 12,000.

‘The post-war generation, old people now, had a liberal upbringing and have strong ideas about the end of their lives,’ he reportedly said. ‘I expect that the nationwide figures will double in the next eight years given the growing numbers of old people.’

Last year, according to the latest report from the RTE body which analyses all cases, there were 6,361 cases of euthanasia, a growth from the previous year but still less than the peak in 2017. Just over 4% of the country’s total deaths were through euthanasia, and 91% of these were for terminal medical conditions such as cancer and lung problems.

Complex

Requests made to the Expertisecentrum Euthanasie – set up as an option for treatment when people’s GP cannot or will not help – increased by 15% last year and Pleiter told Trouw that the center granted euthanasia to 900 people.

It is specialized in making a decision for complex requests such as for people with (advanced) dementia or psychiatric complaints, representing 2.5% and 1% of 2019 euthanasia deaths respectively. Last year, two people were given euthanasia when they had advanced dementia, according to the RTE.

The 2002 euthanasia law has strict conditions [in Dutch] for requesting euthanasia from a doctor, including that the suffering is experienced as unbearable, there are no alternative treatments and that an independent doctor has confirmed the diagnosis. ‘We have shown that with a number of conditions euthanasia is still possible, while we thought in 2012: “that could be complex,”’ Pleiter reportedly said to Trouw.

Limits

However, concerns have been growing about the limits of the law in the Netherlands. Earlier this year, the Supreme Court overturned a murder verdict for a doctor who had given a woman with advanced dementia a sedative in her coffee and asked her relative to hold her down when she appeared to draw back from the lethal injection.

This was the first ever court case around the law alleging murder, and public prosecutors said they pursued it to get legal clarity on cases of advanced dementia and whether a written ‘advance directive’ can stand for a person’s wishes when they can no longer express them. The Supreme Court ruled this was acceptable.

Meanwhile, D66 MP Pia Dijkstra has now submitted controversial draft legislation that would allow over 75s to request euthanasia without advanced suffering but because they feel their lives are complete.
 

Palinurus

The Living Force
Source: Waiting time for mental health related euthanasia request now 2 years: report

Waiting time for mental health related euthanasia request now 2 years: report

By Janene Pieters on Friday, 18 September 2020 - 09:16


Mental Health Care - Photo: lightsource/DepositPhotos


People with a mental illness who request euthanasia are facing longer and longer waiting times before they can get help. Since December, the waiting time at the Euthanasia Expertise Center has doubled to two years, Trouw reports [in Dutch; with five links (all Dutch) to more background info: two case studies and three news articles].

The Expertise Center is finding it impossible to recruit new staff, while the number of requests for help continues to increase. In December, seven psychiatrists worked at the center, already too few. That number hasn't changed. Last year the center received 3,122 mental health related requests for help, 22 percent more than in 2019.

While the corona virus pandemic is an easy thing to blame for the increasing waiting times, the crisis was really only part of the problem, Paulan Starcke of the Expertise Center said to Trouw. According to her, the pandemic caused a maximum delay of two months.

"Our waiting list is primarily a signal that regular mental health care still does not often seriously respond to a request for euthanasia. We are referred to too often," Starcke said.

Patients are referred to the Euthanasia Expertise Center if their regular doctor considers their request too complex to handle themselves. The Expertise Center provided euthanasia to over 60 people with mental health problems last year. Doctors who are not affiliated with the center only did so six times, according to the newspaper.

Starcke wants more psychiatrists to handle euthanasia requests themselves. That is also in the best interest of the patient, because their psychiatrist knows them better than the doctors at the Expertise Center, she said.


Similar: Euthanasia centre has two year wait to assess mental health complaints - DutchNews.nl
 

Palinurus

The Living Force
Source: Euthanasia for terminally-ill children has Dutch coalition divided

Friday, October 9, 2020 - 12:00

Euthanasia for terminally-ill children has Dutch coalition divided


The Rutte III cabinet is clashing over a plan to allow doctors to provide euthanasia for terminally ill children between the ages of 1 and 12 who are suffering unbearably. The D66 and VVD support this plan. But the Christian parties, ChristenUnie in particular, are vehemently opposed, AD reports (in Dutch).

In the Netherlands, there are rules in place for doctors to provide euthanasia for children over the age of twelve as well as for babies up to one year old. But no such arrangement is in place for the in-between kids with terminal illnesses. These children are considered unable to consent, so they can not request euthanasia.

According to AD, doctors are only allowed to give palliative sedation to children in this age group, or allow them to die by withholding nutrition, which can be a lengthy process.

Last year the government had a report drawn up to feel out support for euthanasia for terminally ill children. A large part of doctors, parents and a majority in parliament, including the VVD and D66, were in favor. The report also showed that there are a handful of cases per year of children suffering unbearably and hopelessly while they wait for their illness to take them.

After the report, the topic disappeared from the agenda for a time, until Minister Hugo de Jonge of Public Health "put the dilemma on the table" to "start an open discussion" during a coalition meeting this week, insiders told AD. Prime Minister Mark Rutte (VVD) supported him in this, the insider said.

That sparked fierce resistance from ChristenUnie, according to the newspaper's sources. The Christian party "slammed the brakes", calling it inappropriate to rush this discussion with only five months to go before the parliamentary election.

Parliament will debate medical-ethical issues like this one with the cabinet next week.

Related previous posts: #165 (December 4, 2019); #181 (March 6, 2020).
 

Palinurus

The Living Force
Similar coverage: Dutch parliament to discuss possible new laws to help suffering children to die - DutchNews.nl

[...]

Reports in some Dutch papers have suggested that the issue is likely to split the coalition. A spokesman for the ChristenUnie party, widely considered the most opposed, told DutchNews.nl that it does not oppose palliative sedation – strong painkilling sedatives which Dutch guidelines say can be given to adults if death is expected within 12 weeks.

‘There is a whole spectrum,’ he said. ‘We are against euthanasia for children, who are not considered mentally competent, but we have nothing against palliative sedation. Between them, there are a lot of different possibilities and the question is what the formal proposal will be. Actively ending a life is a very difficult and nuanced question and what are the boundaries?’

[...]
 

Palinurus

The Living Force
Continued coverage of the issue of very ill little children, ahead of the upcoming parliamentary debate on Thursday.

The Dutch government will not follow the example of Belgium, i.e. no lowered age limit within the euthanasia law. The existing law will stay unchanged. For alleviating the plight of very ill young children between one and twelve years of age --5 to10 cases a year, on average-- a special regimen will be formulated to provide medical professionals with more guidance, a wider scope of action and legal protection.

Coverage in English:
Coalition agrees to support 'active termination of life' for younger children - DutchNews.nl
Euthanasia proposal readied for children aged 1 to 12

Coverage in Dutch:
Actieve levensbeëindiging straks toegestaan voor kinderen met uitzichtloos lijden
(includes link to real life example)
Kabinet staat levensbeëindiging toe voor ongeneeslijk zieke kinderen tot 12 jaar
(includes 386 reactions of readers, and counting)
Politieke deal over levenseinde doodziek kind
 

Palinurus

The Living Force
Source (Dutch only): Nieuw-Zeeland stemt via referendum voor legalisering euthanasie

NOS News - Abroad - today, 03:52 am

New Zealand votes by referendum for legalization euthanasia


Residents of New Zealand voted in a binding referendum for the legalization of euthanasia. The decriminalization of cannabis for recreational use was also discussed, but it seems that this proposal will not be adopted.

When the preliminary results were announced, it was said that almost half a million votes still need to be counted. That is not enough to change the vote for euthanasia.

Over 65 percent of voters have so far voted in favor of the euthanasia law, 34 percent voted against. It was already expected that the law would be approved. Both Prime Minister Ardern and opposition leader Collins expressed their support for the law, which will enter into force next November.

The euthanasia law makes assisted suicide possible. This applies to terminally ill people who are likely to die within six months and people who are suffering unbearably.

With this law, New Zealand joins a small group of countries. Luxembourg, Canada, Belgium, Colombia and the Netherlands previously legalized euthanasia.

Legalization of cannabis

Under the proposed change in legislation on marijuana, people in New Zealand could buy 14 grams a day and grow two plants. With this proposal, voters for and against stayed closer together. So far, more than 53 percent voted against the legalization. 46 percent voted in favor. This leaves a small chance for a change in the law with the votes that still have to be counted.

The overseas votes, among others, still need to be counted. New Zealanders who vote from abroad are often more liberal. The final result of the referendums will be announced next Friday.


Translated with www.DeepL.com/Translator (free version)

Similar: Nieuw-Zeeland stemt voor legaliseren euthanasie
 

Mariama

Ambassador
Ambassador
FOTCM Member
Here is RT's coverage of the same news item:
Opponents expressed concern that legalizing euthanasia would contradict suicide prevention campaigns and would pressure terminally ill people to choose assisted dying in order to be less of a burden to family.

Although considered taboo in most parts of the world, campaigners to legalize euthanasia have scored a number of victories in recent years. Earlier this month, the Dutch government said it would allow doctors to euthanize terminally ill children as young as one year old, making the Netherlands only the second country in the world to permit the practice.
It is interesting that New-Zealand while being in the throes of Rona can find the time to legalise euthanasia aka assisted suicide.:whistle:
 

Palinurus

The Living Force
Source: NL expanding rules on euthanasia for dementia patients

Saturday, November 21, 2020 - 08:15

NL expanding rules on euthanasia for dementia patients


The Netherlands' five regional euthanasia review committees RTEs announced that they are adjusting the assessment criteria in the Euthanasia Code on four points, specifically for doctors who get a euthanasia request from a dementia patient. The goal is to make it easier for doctors to grant such requests. "Doctors now have to worry less about putting their necks in a noose with euthanasia," RTEs chairman Jacob Kohnstamm said to the Volkskrant [in Dutch]. "They can be less afraid of the judiciary. Or of the review committees."

The updated Euthanasia Code says that a dementia patient's statement requesting euthanasia does not have to be legally perfect. The statement, in which the patient describes the circumstances under which they want euthanasia, can sometimes be interpreted in multiple ways. Doctors will now have more room to interpret what the patient meant, for example by consulting family members.

Doctors will also be allowed to give a sedative to advanced dementia patients if they expect the patient will become aggressive or restless because they don't understand what's happening. The doctor also does not have to request a verbal confirmation from a patient with advanced dementia before the euthanasia procedure is performed. "Such a conversation is pointless, because such a patient lacks understanding of these topics," is stated in the code.

And it will be up to the doctor to assess whether a patient is suffering unbearably and hopelessly, the updated code reads. "The RTE should test that medical professional judgment with caution."

These adjustments were based on a Supreme Court ruling in a case against nursing home doctor Marinou Arends - the first doctor to be prosecuted for euthanasia in the Netherlands.

Arends was charged with murder after performing euthanasia on a patient with advanced dementia. The doctor put a sedative in the woman's coffee before the procedure, because she worried that the woman - who had attacked people in the nursing home - would fight the IV because she didn't understand what was happening. The review committee accused the doctor of "secretly" drugging the patient, and said that the patient's euthanasia request was also not clear.

The subsequent trial lasted for years. After the court in The Hague acquitted the doctor of all charges last year, the Supreme Court also ruled in her favor in April. During the trial, the Prosecutor also said that the case was less about getting a doctor convicted, and more about getting clarity for future cases. The RTEs adjusted their criteria after the ruling.

Every year, doctors perform euthanasia for around 6 thousand patients in the Netherlands. The review committees assess the cases afterwards, and pass cases to the Public Prosecutor if all the criteria was not met. According to Kohnstamm, euthanasia is very rare for people with advanced dementia, only happening two or three times a year.

Similar, but expanded: More room for doctors to grant euthanasia to deeply demented patients - DutchNews.nl

Coverage in Dutch:
Wilsverklaring krijgt meer gewicht bij euthanasie
Regels voor euthanasie bij dementerenden worden verruimd
 
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