Euthanasia

Palinurus

The Living Force
Update on post #105 (September 28, 2017).

Source: Formal reprimand for doctor who performed euthanasia on dementia patient - DutchNews.nl

July 24, 2018

A doctor who performed euthanasia on a woman with severe dementia has been given a formal reprimand by the Dutch medical complaints board.

The case centers on a 74-year-old woman, who was diagnosed with dementia five years ago. At the time she completed a living will, saying she did not want to go into a home and that she wished to die when she considered the time was right.

After her condition deteriorated, she was placed in a nursing home where she became fearful and angry and took to wandering through the corridors at night. The nursing home doctor reviewed her case and decided that the woman was suffering unbearably, which would justify her wish to die.

The doctor put a drug designed to make her sleep into her coffee which is against the rules. She also pressed ahead with inserting a drip into the woman’s arm despite her protests and asked her family to hold her down, according to the official report on the death. This too contravenes the guidelines.

The medical complaints committee said the doctor was at fault for not trying to discuss the decision with the patient. The doctor has already been given a formal reprimand by the euthanasia complaints council for breaking the guidelines and the public prosecution department is also investigating the case.

Once the public prosecution department has finished its investigation it will decide whether or not the doctor, a specialist in geriatric medicine, should face criminal charges.The doctor has since retired.

Legislation

In 2016, the justice and health ministries relaxed the guidelines for performing euthanasia on people with severe dementia a little so that patients can be helped to die even if they incapable of making their current feelings known.

However, they do have to have signed a euthanasia declaration with their family doctor before they become too seriously ill to be considered for help in dying.

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.

Since the legislation was introduced in 2002, there have been a number of controversial cases, including a woman suffering severe tinnitus and a serious alcoholic.
 

Gary

The Living Force
FOTCM Member
Source: Doctors and families do not need legal permission to allow vegetative patients to die, court rules (UK court ruling).

End-of-life care: Doctors and families do not need legal permission to allow patients to die, court rules

No need for judge approval where experts and loved ones are in agreement about withdrawing food and water in best interests of patients unlikely to regain consciousness

Families will no longer need to go before the courts for approval to withdraw feeding tubes from loved ones in a permanent vegetative state, after a ruling by the UK’s highest court upheld the end of life decision making of a man with an extensive brain injury.

The 52-year-old, who can only be identified as Mr Y, had been in a vegetative state since June 2017. Experts said it was improbable he would ever regain consciousness and agreed with the family members’ decision to withdraw hydration and nutrition – something that usually requires approval from the Court of Protection.


Groups representing people with diminished capacity had appealed an earlier High Court ruling allowing this withdrawal, and Mr Y died in December while still being artificially fed. This appeal was dismissed by the Supreme Court on Monday, with lawyers warning a “vital legal safeguard” has now been compromised.

The decision means that where doctors and families are in agreement of the best interests of patients then there should be no need for a judge’s authorisation – a process which can take years to complete and cost local health authorities tens of thousands of pounds in legal bills for appeals.


Mr Y’s condition was classed as a prolonged disorder of consciousness (PDOC), which covers comas, vegetative and minimally conscious states after a brain injury. If he were to regain consciousness his doctors said he would likely have profound physical and cognitive disabilities and would be dependent on others for his care.

Though he had not drawn up an advance decision notice saying he would decline treatment in the event of falling into a vegetative state, Mr Y’s family were of the view that he would not want to be kept alive.

His family and doctors had agreed on a plan to withdraw clinically assisted nutrition and hydration (CANH), which would lead to him dying naturally within two to three weeks.

In November 2017, a High Court judge granted a declaration that it was not mandatory to bring before the court the withdrawal of CANH from Mr Y in circumstances where there was no dispute between his relatives and specialists.


She gave permission for an appeal by the official solicitor – who represents people who lack mental capacity – and CANH was provided in the meantime, but Mr Y died in December.

It was decided that the appeal before five Supreme Court justices should proceed because of the general importance of the issues raised.

Richard Gordon QC, for the official solicitor, said that the central issue was whether the obtaining of an order from the Court of Protection, before CANH could lawfully be withdrawn from a person in a PDOC, was unnecessary where treating clinicians and the family agreed it was not in the patient’s best interests.


He added: “This case is not about whether it is in the best interests of a patient to have CANH withdrawn. It is about who decides that question.”

Although the official solicitor accepts there is no statutory requirement to bring such cases to court, he argues that the common law or human rights law require that every case involving the withdrawal of CANH be the subject of a best interests application regardless of whether there is a dispute.

On Monday, the justices unanimously dismissed the appeal.

Lady Black, a Supreme Court justice, said: “Having looked at the issue in its wider context as well as from a narrower legal perspective, I do not consider that it has been established that the common law or the ECHR (European Convention on Human Rights), in combination or separately, give rise to the mandatory requirement, for which the official solicitor contends, to involve the court to decide upon the best interests of every patient with a prolonged disorder of consciousness before CANH can be withdrawn.


“If the provisions of the MCA 2005 (Mental Capacity Act) are followed and the relevant guidance observed, and if there is agreement upon what is in the best interests of the patient, the patient may be treated in accordance with that agreement without application to the court.”

She emphasised that, although application to court was not necessary in every case, there would undoubtedly be cases in which an application would be required – or desirable – because of the particular circumstances and there should be no reticence about involving the court in such cases.

“The court heard evidence that it is difficult even to diagnose some of the conditions,” said David Foster, a partner at Barlow Robbins law firm who has been involved in many of the major end of life cases in the past 12 years and acts as an intervener for the Care Not Killing alliance.

“The oversight of the official solicitor was helpful and we fear a vital legal safeguard has been compromised for those who are the most vulnerable.”
 

Palinurus

The Living Force
BBC's Radio Four recently dedicated a program to the Aurelia Brouwers case already mentioned on March 28, 2018 in Reply #115, then in response to an article in the Guardian newspaper.

The troubled 29-year-old helped to die by Dutch doctors (eight photos omitted):

The troubled 29-year-old helped to die by Dutch doctors

By Linda Pressly BBC News, The Netherlands
9 August 2018

In January a young Dutch woman drank poison supplied by a doctor and lay down to die. Euthanasia and doctor-assisted suicide are legal in Holland, so hers was a death sanctioned by the state. But Aurelia Brouwers was not terminally ill - she was allowed to end her life on account of her psychiatric illness.

"I'm 29 years old and I've chosen to be voluntarily euthanized. I've chosen this because I have a lot of mental health issues. I suffer unbearably and hopelessly. Every breath I take is torture…"

A team from the Dutch TV network, RTL Nieuws spent two weeks recording Aurelia as she journeyed towards her date with death - 2pm on Friday, 26 January. On a whiteboard in her home, she crossed off the days with a heavy black marker pen.

During those last weeks, she spent her time with loved ones, doing craftwork and riding her bike in Deventer, the city she adored. She also visited the crematorium - the place she had chosen for her own funeral service.

In many ways her story is uniquely Dutch. Euthanasia is against the law in most countries, but in the Netherlands it is allowed if a doctor is satisfied a patient's suffering is "unbearable with no prospect of improvement" and if there is "no reasonable alternative in the patient's situation".

These criteria may be more straightforward to apply in the case of someone with a terminal diagnosis from untreatable cancer, who is in great pain. And the vast majority of the 6,585 deaths from euthanasia in Holland in 2017 were cases of people with a physical disease. But 83 people were euthanized on the grounds of psychiatric suffering. So these were people - like Aurelia - whose conditions were not necessarily terminal.

Aurelia Brouwers' wish to die came with a long history of mental illness.

"When I was 12, I suffered from depression. And when I was first diagnosed, they told me I had Borderline Personality Disorder," she says. "Other diagnoses followed - attachment disorder, chronic depression, I'm chronically suicidal, I have anxiety, psychoses, and I hear voices."

Aurelia's doctors would not endorse her requests for euthanasia. So she applied to the Levenseindekliniek - the End of Life Clinic - in The Hague. This is a place of last resort for those whose applications have been rejected by their own psychiatrist or GP. The clinic oversaw 65 of the 83 deaths approved on psychiatric grounds in Holland last year, though only about 10% of psychiatric applications are approved, and the process can take years.

"The psychiatric patients we see are younger than others," says Dr Kit Vanmechelen, a psychiatrist who assesses applicants and performs euthanasia, but was not directly involved in Aurelia's death.

"Aurelia Brouwers is an example of a very young woman. And that makes it harder to make the decision because in those cases, you take away a lot of life."

During her last two weeks of life, Aurelia was often distressed and had self-harmed.

"I'm stuck in my own body, my own head, and I just want to be free," she said. "I have never been happy - I don't know the concept of happiness."

"She was really not as stable during the day," remembers Sander Paulus, the RTL Nieuws journalist who spent much of that last fortnight with her. "You just felt there was a lot of pressure in her head. She didn't speak that well any more - except when we talked about euthanasia. She was very clear on that."

But does clarity mean someone has the mental capacity to choose death over life? According to Dutch law, a doctor must be satisfied a patient's request for euthanasia is, "voluntary and well-considered".

Aurelia Brouwers argued she was competent to make the decision. But could a death wish have been a symptom of her psychiatric illness?

"I think you never can be 100% sure of that," says Kit Vanmechelen. "But you must have done everything to help them diminish the symptoms of their pathology. In personality disorders a death wish isn't uncommon. If that is consistent, and they've had their personality disorder treatments, it's a death wish the same as in a cancer patient who says, 'I don't want to go on to the end.'"

This view is not universally held by psychiatrists in the Netherlands.

"How could I know - how could anybody know - that her death wish was not a sign of her psychiatric disease? The fact that one can rationalize about it, does not mean it's not a sign of the disease," says psychiatrist Dr Frank Koerselman, one of Holland's most outspoken critics of euthanasia in cases of mental illness.

He argues psychiatrists should never collude with clients who claim they want to die.

"It is possible not to be contaminated by their lack of hope. These patients lost hope, but you can stay beside them and give them hope. And you can let them know that you will never give up on them," he says.

Aurelia Brouwers' death provoked huge debate in the Netherlands, and made headlines around the world. No-one has suggested it was illegal, although critics have asked whether it was the kind of case for which the 2002 legislation allowing euthanasia was enacted.

Opinions divide on whether there was an acceptable alternative. For example Kit Vanmechelen argues that when people apply for euthanasia on psychiatric grounds, in some cases they will kill themselves if they don't get it. In her view, they should be regarded as people with terminal illnesses.

"I've treated patients that I knew were going to commit suicide," she says. "I knew. They told me, I felt it, and I thought, 'I can't help you.' So to have euthanasia as an alternative makes me very grateful we have a law. The ones I know will commit suicide are terminal in my opinion. And I don't want to abandon my patients who are not able to go on with their lives. That makes me willing to perform euthanasia."

"I simply disagree," says Frank Koerselman. "My whole career I worked with suicidal patients - none of them was terminal. Of course I had patients who committed suicide, but as a matter of fact these were always cases when you didn't expect it."

In RTL's film, Aurelia Brouwers talks about attempts to end her own life.

"I think I tried about 20 times. I was critical a few times, but I often got to hear that my heart and lungs were so healthy. The doctors said, 'It's a miracle, she made it.'"

And surviving a suicide attempt is not unusual - people do it every day.

Monique Arend, like Aurelia Brouwers, was diagnosed with psychiatric illness including Borderline Personality Disorder. People with this condition may self-harm, have intense feelings of anger, find it hard to sustain relationships, and experience emotional instability. Monique made many attempts to kill herself.

"It happened everywhere - at home, in the forest... But I'm very grateful I'm still alive today," she says.

Monique is a survivor of violent sexual abuse, and terrifying psychiatric episodes. She thought long and hard about euthanasia.

"I thought I was a big problem for everyone, and I just didn't want to be that burden, and the pain became unbearable. So I requested the forms for euthanasia, and filled them in. But I never filed them."

Monique did not file those papers because she found help. In the early days of her illness, a counselor had advised her not to talk about the abuse - this is when she began to self-harm. But then she found a new therapist who specialized in trauma.

"She told me I'm not crazy, but I'm traumatized - that's a big difference. We worked very hard together - it was very painful. But we went through it, and since then I've been on a recovery trip," Monique says.

She has written a book about her experiences, and has some advice for people struggling with suicidal thoughts or considering euthanasia in Holland.

"It's heavy, hard and tough," she says. "But keep a candle burning. Look for people who can support you. You guys are so powerful because you've been through so much - there's still room for you on this planet."

The discomfort around euthanasia for psychiatric patients is partly to do with a concern that all options may not have been explored. At the End of Life Clinic in The Hague more than half of those who come seeking euthanasia on psychiatric grounds are turned away because they have not tried all available treatments.

"I had a patient who had a lot of treatments, and was convinced nothing more could help him. But he had never been in a clinic to help with abuse of prescription medicine and alcohol," says Kit Vanmechelen. "So I said to him, 'For half a year you must make a real effort to lessen your use of those, and if then you still have a death wish, well, come back and we'll talk.'"

But Vanmechelen believes that after a patient has undergone multiple treatments for the same diagnosis, it is reasonable to say, enough is enough.

This was what Aurelia Brouwers argued too. She had been treated for her illness - she had therapy and took medication - but we do not know the details.

"We need to get rid of the taboo that you should always remain in treatment, until the bitter end," she said. "For people like me there isn't always a solution - you can't keep taking medicine, you can't pray indefinitely… At some point you just have to stop."

But people can and do live for decades with psychiatric disorders.

"They're not treatable like an infection, they're like diabetes - you've got the disease, you will have it the rest of your life, but we, as doctors, are going to make it possible for you to live with it," argues Frank Koerselman.

"Like people with diabetes, psychiatric patients are also treated for years, but this is not an argument to stop treatment.

"It's very well known that after the age of 40 things might go much better for people with Borderline Personality Disorder - their symptoms might become much milder."

Aurelia Brouwers died more than a decade before she reached 40. On her last full day on Earth she was visited by her favourite singer, Marco Borsato. That night, she had dinner with her friends - there was laughter, and a toast. On the morning of 26 January she posted for the final time on social media:

"I'm getting ready for my trip now. Thank you so much for everything. I'm no longer available from now on."

Aurelia Brouwers' loved ones assembled in her bedroom. Two medics were in attendance.

"I'm sure that the moment I give the poison - because that's what you do, you give poison - I'm very sure that is the only thing the patient wants at that moment and has wanted for a long period, otherwise I wouldn't be able to do it," says Kit Vanmechelen.

"In the first meeting with a patient, I tell them, this will be the last question I ask you: 'Are you sure you want this? And if there is a little doubt, we will stop, come back, and talk about it again.'"

And has that ever happened to her?

"No. It doesn't happen."

In Aurelia's case, doctors did not administer the drugs that killed her - she drank the medication herself.

In the RTL Nieuws documentary, she has a last conversation with Sander Paulus, as she holds the small, sealed medicine bottle.

"This is the drink," she says. "I know it tastes bitter, so I'm just going to drink it down. And then I'm going to sleep."

Sander Paulus asks her if she has any doubts.

"No doubts," Aurelia says. "I'm ready - ready to go on a journey."

"I hope you find what you're looking for," he says.

"I definitely will," is Aurelia's reply.

Aurelia Brouwers turns her back on Sander Paulus, and climbs the stairs. It is just after 2pm on Friday, 26 January, 2018.

NOTE: The RTL Nieuws documentary (in Dutch, no subs) is still available here after free registration to log in.
 

Palinurus

The Living Force
Source: Living wills are often too old to sanction euthanasia: research - DutchNews.nl

Living wills are often too old to sanction euthanasia: research

August 22, 2018

A large number of the euthanasia declarations signed by people in the Netherlands are useless because they have not been regularly updated, according to research by a Dutch family doctor.

Matthijs van Wijmen has followed thousands of people who have set down their wish to die by euthanasia should they become senile, incapacitated or terminally ill.

However, doctors cannot perform euthanasia on the basis of an old declaration, and fewer than half of people with a living will update it, Van Wijmen told Trouw on Wednesday (Dutch only).

Anyone can draw up a living will but the two Dutch voluntary euthanasia societies publish standard versions. However, just 42% of NVVE and 28% of NPV members had discussed their wishes with their family doctor within the six year period of the research, meaning their declarations were likely to be considered void, Van Wijmen found.

There is no official guideline for determining how often a living will should be updated. However, earlier this year a doctor was reprimanded by the euthanasia regulatory body because she had carried out euthanasia on someone whose living will was five years old.

‘This [is] one of the most pressing issues,’ an NVVE spokesman told Trouw. ‘We are in talks with doctors about coming up with guidelines.’

Rules

In 2016, the justice and health ministries relaxed the guidelines for performing euthanasia on people with severe dementia a little so that patients can be helped to die even if they are incapable of making their current feelings known.

However, they do have to have signed a euthanasia declaration with their family doctor before they become too seriously ill to be considered for help in dying.

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.
 

Palinurus

The Living Force
Source: Fewer cases of euthanasia last year; doctors' concerns may be to blame - DutchNews.nl

Fewer cases of euthanasia last year; doctors’ concerns may be to blame

October 16, 2018

The number of reported cases of euthanasia has fallen for the first time since the practice was formalized in 2002, Trouw reported [in Dutch] 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 reduction. ‘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.
 

Palinurus

The Living Force
Source: Doctor will not be prosecuted for euthanasia of semi-conscious woman of 72 - DutchNews.nl

Doctor will not be prosecuted for euthanasia of semi-conscious woman of 72

October 26, 2018 - By Senay Boztas

Prosecutors will not pursue a case against a doctor who performed euthanasia on a 72-year-old woman in a state of semi-consciousness, the public prosecutor announced on Friday [Dutch only].

The case in April 2017 was one of a number referred to the public prosecution for potentially breaking strict rules by the Regional Euthanasia Review Committees, which assesses all cases each year.

She had advanced and incurable cancer, was suffering ‘unbearably’, and two days before the procedure had a cerebral hemorrhage resulting in a coma. Afterwards, she found it difficult to speak and was less aware of her surroundings.

The public prosecution service, however, said it was convinced that the woman’s wish for euthanasia was voluntary, well-considered, and that she could properly communicate her wishes by nodding her head and gesturing with her hands.

‘This meant that a written declaration of intent was not necessary,’ said the service in a news release. She had also expressed her wish for euthanasia several times before the brain hemorrhage, and was clearly in pain and suffering unbearably with no hope of treatment, it concluded.

The RTE had referred on the case (2017-73) saying that the doctor breached its criteria for due care but the public prosecutor has confirmed that the doctor – who has not been named – did ‘act in accordance with care standards’.

Another four criminal investigations are underway into other euthanasia cases, and earlier this year Trouw reported that numbers are apparently falling for the first time since the 2002 euthanasia law – possibly due to increased criminal investigations.
 

Palinurus

The Living Force
Archiving the latest from SOTT (Will Maule - Faithwire - Wed, 17 Oct 2018):

Canadian hospital releases assisted suicide plan for kids, may not even inform parents -- Sott.net

A group of medics from a Toronto children's hospital have released a shocking paper which outlines its controversial position on child euthanasia. In the paper, published at the British Medical Journal, Toronto's Hospital for Sick Children revealed that in some cases, the young person's parents will not be notified of the intention to end their own lives until after the death is confirmed.

"Usually, the family is intimately involved in this (end-of-life) decision-making process," the pediatric doctors, administrators and ethicists noted in a Sept. 21 paper published in the BMJ.
"If, however, a capable patient explicitly indicates that they do not want their family members involved in their decision-making, although health care providers may encourage the patient to reconsider and involve their family, ultimately the wishes of capable patients with respect to confidentiality must be respected."​
In the east-central Canadian province of Ontario, parents are not required to be involved in any "capable" child's decision to end their own life.

It is a terrifying prospect - that a child could choose to engage in physician-assisted suicide without the involvement of their own parents. Obviously, this has caused grave concern among certain ethicists and pro-life researchers.

"It is not difficult to imagine how such a protocol could wreak havoc on society," commented Monica Burke, a research assistant in the DeVos Center for Religion and Civil Society at The Heritage Foundation. "When a culture differentiates between lives worth living and lives worth ending, the consequences to vulnerable populations - the young, the old, the sick, and disabled - are disastrous."

Burke added that, as a result of the twisted and dark progression of euthanasia legislation, "those who most require our compassion and protection become the most likely to be pressured to prematurely end their lives." We can be sure that a truly heinous cultural moment has arrived when children are offered "suicide assistance" instead of "suicide prevention."

The scholar noted that this Canadian hospital's ethically bankrupt policy is a clear-cut signal that there is now "no natural, logical limit to who qualifies for physician-assisted suicide." Assisted suicide is on its way to becoming utterly indiscriminate, with little legal constraint and a subsequent whittling away of the sanctity of life.

But despite Canada's insatiable penchant for liberalizing euthanasia laws, a damning study published by the Canadian Institute for Health Information revealed that a mere 15 percent of dying Canadians have access to quality palliative during the last year of their life. Indeed, it is clear that the legislative emphasis has been placed on the ending of life, rather than the sustaining of it.

"We all know that in Canada, an ER visit for a frail elderly person (the main clientele for palliative care) means lying on a gurney in a hallway for hours," wrote André Picard at Canadian newspaper, the Globe and Mail. "That is the last place a dying person - often confused, incontinent and in pain - should be. This kind of humiliation is untenable and we should be ashamed at how commonplace it is."

Earlier this year, a leading American bioethicist backed a Dutch law that effectively eradicates all age limits for euthanasia - meaning children can be medically, and legally, executed. Presently, euthanasia in The Netherlands is legal starting at age 12. You would expect that American experts would be appalled by this law, but that's not the case. U.S. Ethics Professor Margaret P. Battin actively supported it, and essentially advocated for the 2004 infant euthanasia policy called the "Groningen Protocol."

The Protocol contains directives with criteria under which physicians can perform "active ending of life on infants" without fear of prosecution.
"I generally support [the] change in Dutch law governing eligibility for euthanasia.‍ Given that euthanasia is currently legal for infants <1 year of age and children and adults >12 years of age, I believe that opponents would have to show evidence that at least 1 and perhaps many of the following propositions are true if they are to persuade you [a hypothetical Dutch health minister] not to support the change in the law," Prof. Battin said in a round-table discussion on the issue in the Pediatrics journal.​
Battin then listed a few shocking propositions that must be proved wrong, one of which being, "parents aren't harmed by seeing their children suffer." So, if a parent feels that they are suffering from the sight of their child going through pain, it is OK to "put them down."

Euthanasia is illegal in most of the United States, with exceptions made in California, Colorado, Oregon, Vermont, Hawaii and Washington.
 

Palinurus

The Living Force
Source: Euthanasia doctor faces prosecution over dementia patient death - DutchNews.nl

Euthanasia doctor faces prosecution over dementia patient death

November 9, 2018

A geriatric doctor who helped a nursing home patient with severe dementia to die will be prosecuted for breaking euthanasia guidelines the public prosecution department said on Friday.

The case will be the first to come to court since the guidelines were established by law 2002. The doctor was given a formal reprimand earlier this year after the case was highlighted by the regional euthanasia monitoring committee.

‘This case addresses important legal issues regarding the termination of life of dementia patients,’ the department said in a statement. ‘This case has been referred to court to get these questions answered.’

The case centers on a 74-year-old woman who had drawn up a living will some years before her admission to the nursing home, ‘but it was unclear and contradictory’, the department said.

‘Although the woman had regularly stated that she wanted to die, on other occasions she had said that she did not to want to die,’ the department said in a statement.

‘The department believes the doctor should have checked with the woman whether she still had a death wish by discussing this with her,’ the statement said. ‘The fact that she had become demented does not alter this, because the law also requires the doctor to verify the euthanasia request in such a situation.’

Two other cases referred to the public prosecutor by the monitoring committee are still being assessed.

Controversy

In 2016, the justice and health ministries relaxed the guidelines for performing euthanasia on people with severe dementia a little so that patients can be helped to die even if they incapable of making their current feelings known.

However, they do have to have signed a euthanasia declaration with their family doctor before they become too seriously ill to be considered for help in dying.

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.

Since the legislation was introduced in 2002, there have been a number of controversial cases, including a woman suffering severe tinnitus and a serious alcoholic.

Similar coverage here: Dutch to prosecute doctor in euthanasia case; A first since legalizing assisted suicide
 
Top Bottom