Euthanasia

[Palinurus]

Source (Dutch only): ‘Euthanasie bij kinderen is moeilijk, dat moet zo blijven’

End of life
'Euthanasia in children is difficult, it has to stay that way'

Theo Boer, professor at the Protestant Theological University Groningen - Image reyer boxem

Ethicist Theo Boer is not against euthanasia in children, but against legal rules for it. 'When a child suffers unbearably, you have to be able to apply far-reaching palliation.'

Marten van de Wier - 6 March 2020, 14:53

The ending of life of children who cannot ask for euthanasia themselves falls into a 'twilight zone'. And that's where it has to stay. This is what medical ethicist Theo Boer argues today on the occasion of his farewell as professor of ethics at the Theological University of Kampen. Boer has become a professor at the Protestant Theological University of Groningen.

He is known as a critic of the current Dutch euthanasia practice. Nevertheless, Boer is not opposed to doctors ending the life of a seriously suffering little patient in exceptional cases. Laying this down in a regulation goes too far, he thinks.

A majority of pediatricians do believe that a regulation should be made for children between 1 and 12 years of age. This was the conclusion of a study conducted last autumn by pediatrician Eduard Verhagen of the University Medical Center Groningen, commissioned by the Ministry of Public Health. The Cabinet will soon decide what it will do with the results.

"I do understand the call of physicians," says Boer. "Maybe it is the result of straightforward Calvinism, but in the Netherlands there is merciless action against those who do not paint within the lines." Boer cites as an example the general practitioner from Tuitjenhorn who was suspended in 2013 by the Health Care Inspectorate after giving a large dose of painkillers to a dying patient. Subsequently, physician Nico Tromp put an end to his life and was only rehabilitated years later in court.

Boer believes that Tromp was wrongly tackled. Society should have more respect for medical action in the twilight zone, he states. "Trust doctors when they are somewhat creative with the morphine syringe. That's how they've done it over the centuries."

Recourse to force majeure

A doctor should be able to end a child's life in exceptional situations, Boer believes. "When a child suffers heartbreakingly but does not respond to painkillers, or is allergic to them," says the professor.

In addition, according to him palliative sedation can be applied generously. It puts an adult or child into a deep sleep to relieve the suffering. Patients sometimes die sooner as a 'side effect'. According to the physician's standards, it is allowed to induce patients with a life expectancy of no more than two weeks into deep sleep. "When a child suffers unbearably, I think you should be able to apply far-reaching palliation, even if that accelerates death in a child that might have a long life to live," says Boer.

According to the law, physicians already have the possibility to end children's lives, Boer claims, invoking 'force majeure', if there is nothing else they can do against the suffering. According to pediatrician Verhagen and his fellow researchers, that gives doctors insufficient legal certainty.

"I understand that doctors want a settlement, but the arguments against it are more weighty for me," says Boer. "That we only kill people who ask for it, is a cornerstone of our euthanasia system." He fears that when there will be an arrangement for children, other groups could follow later: patients who, like incapacitated children, are not able to discuss their own death.

He believes that doctors should take responsibility. "If they end a child's life, let them report it. Let them stand up for their actions. It's difficult, but it must remain difficult."

____________________________________
Euthanasia in children

Euthanasia is possible for children over 12 years of age who endure unbearable and hopeless suffering. They have to grasp what their death means, and for children up to the age of 16 parents have to agree. Also, in the case of newborn children, life can be terminated by a doctor with the consent of the parents. This applies to children who face a life of hopeless and severe suffering.

For children between 1 and 12, life cannot be terminated in accordance with a regulation. This also applies to anyone older than 12 who does not understand what his death means, for example because of an impairment.


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

Other parts of this series (Dutch only):
Marinka wilde haar zoon (4) menswaardig laten sterven, maar euthanasie mocht niet. ‘Dat deed zo'n pijn’
Een jong kind laten sterven, is dat politiek haalbaar?

 

[Palinurus]

Source (Dutch only): Het aantal duo-euthanasieën is vorig jaar verdubbeld

Death
The number of duo-euthanasias doubled last year

More couples get euthanasia together, according to the annual report of the euthanasia committees.

Marten van de Wier - 17 April 2020, 16:59

Partners who are both seriously ill may choose to die together. More couples than before arrange such joint euthanasia, according to the annual figures of the Regional Euthanasia Review Committees. Last year it was 17 couples, or 34 patients. That is almost a doubling: in 2018 there were 9 couples (18 patients).

There are no figures from before 2018, but the review committees have been seeing an increase for several years. That was the reason for actually counting the number of 'duo-euthanasias' over the past two years. "They are often patients who are, so to speak, both at an angle to one another. That's how they can cope. But if you remove one, the other also falls over," says Jacob Kohnstamm, chairman of the joint assessment committees.

After a slight decline in 2018, the total number of euthanasia cases increased again slightly last year, by 3.8 percent to 6361, according to the annual report. This is less than in record year 2017, when euthanasia was granted 6585 times. It seems the number of euthanasia cases is stabilizing, after years of increase.

Heavy requirements for due diligence

A 'duo-euthanasia' remains rare: it concerns only half a percent of all euthanasia cases. Kohnstamm emphasizes that both partners must independently comply with all due diligence requirements of the euthanasia law. Each must suffer unbearable and hopeless suffering caused by illness. It is rare that this applies to two partners at the same time.

According to the euthanasia code, doctors must also ensure that there is 'no undue pressure' from one partner on the other. After the couple's own physician (or physicians), two independent physicians assess the request of both partners separately.

"A tricky question is: to what extent does one want death because the other also wants death," says Bert Keizer, geriatrics specialist and Trouw columnist. "In theory, that shouldn't play a role. An example: a man is demented and his wife gets colo-rectal cancer. Without her he has to go to a nursing home. If she had lived on, he would have lived on too. Still, the review committee allows you to euthanize in such a case. And I think that's right. A man like that is already suffering, and once she's dead he'll be in nothing but misery."

Romeo and Juliet

Theo Boer, professor of ethics of health care at the Protestant Theological University in Groningen, believes that duo-euthanasia should be possible, for example in partners with advanced cancer. But he gets 'gloomy' from the increase. "For the trend of 'if you go, I go too', like the story of Romeo and Juliet, we really have to be on our guard."

"Often one of the two has a longer life expectancy, and mourning also plays a part in the death wish. This is very understandable from the patient's perspective, because the death of your partner turns your life upside down. The effect is comparable to that of depression," says Boer. Mourning is not a medical reason for euthanasia, and can cloud a patient's capacity for judgement, Boer warns.

Kohnstamm argues that euthanasia is only granted on the basis of suffering with a medical basis. All cases of duo-euthanasia have been carefully re-examined by the assessment committees.

Dick Bosscher, board member of the Dutch Society for a Voluntary End of Life, thinks it is good that requests for duo-euthanasia can be granted. According to him, the increase is related to the fact that more people are familiar with the possibility.

Willem and Marianne Meuwese both suffered from an unbearable and hopeless illness. They died together
last year on request.

Marianne and Willem Meuwese died hand in hand

Marianne and Willem Meuwese did everything together since their retirement. They both painted. They visited art fairs. And when they were still healthy, they went to New York every year for a month to visit museums. They died on December 17 last year. He, former property developer, was 70. She, former speech therapist, 68.

They were both seriously ill. "That they were eligible for euthanasia was obvious," says eldest son Harm, 44. That partners both meet the euthanasia criteria at the same time is exceptional, he knows. "You'd almost say, how did they get it done?"

Willem had been ill for two years. He had cancer in his tailbone. Just when he seemed to be getting better, Marianne had an epileptic fit. A brain tumor turned out to be the cause. Not long after that, the cancer returned to her husband.

"In October last year, we celebrated their 40th wedding anniversary. We hoped that they would both have some time left", says Roel Meuwese (40), their youngest son. At the end of October it became clear that Willem's last stem cell transplant had not caught on. Marianne had a second epileptic seizure at the beginning of December. Her cancer grew rapidly.

"My mother always liked to be in control. Now she lived with a constant fear of a seizure, and of its consequences," says Harm. "The tumor would start to push all sorts of things away. She'd get more and more trouble of it and maybe even go into a coma." Her biggest fear was that she might not be able to ask for euthanasia anymore.

With Willem there was less time pressure, but also for him the disease became more difficult to bear. Body functions fell out. "He had severe pain, much more pain than we expected," says Harm.

At the beginning of December the couple put the question to their sons. What would they think about whether their parents would go together? "It was clear to us," says Harm. "Their bodies were gone. Imagine if one of the two had had to carry on for a short time without the other. That would have been terrible for both of them."

They had breakfast with their sons in the morning. After coffee they went to the bedroom. There they gave each other a hug, and thanked each other for the beautiful life. They drank the euthanaticum themselves, under the supervision of the doctor, their sons around their bed. They died hand in hand, Roel says. "My mother, always in control, only after she saw that my father had fallen into sleep."


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

 

[Palinurus]

Source: Supreme Court clears euthanasia doctor of murdering severe dementia patient - DutchNews.nl

Supreme Court clears euthanasia doctor of murdering severe dementia patient

April 21, 2020

The Dutch Supreme Court on Tuesday upheld a lower court decision in which a doctor who performed euthanasia on a patient with severe dementia was found not to have broken any laws.

The Supreme Court also tore up the written reprimand that the doctor, since retired, had been given by the medical sector’s disciplinary board.

The case first hit the headlines in 2016 because it was the first of its kind involving a doctor who carried out euthanasia on a patient with dementia.

The public prosecution department had accused the doctor of murder arguing she should have done more to establish that the patient wanted to go through with the process. Despite lower courts ruling in the doctor’s favor, the public prosector took the case to the Supreme Court, saying this was necessary not to dispute the verdict, but to clarify the law.

The Supreme Court ruling [in Dutch] now establishes in law that a doctor may honor a written request for euthanasia if the patient is no longer capable of giving their assent because of advanced dementia. The ruling also sets out how all the requirements can be met in this specific situation.

Living will

The case centered on a 74-year-old woman who had drawn up a living will some years before her admission to the nursing home and had regularly stated that she wanted to die.

The doctor told the lower court last year that she had spoken three times to her patient about her wish to die, but not about her living will because ‘she could not remember anything about it’. Her long and short-term memory was shot and she no longer recognized her husband, the doctor said.

The woman’s daughter said in a written statement in court that she had no doubt her mother wished to die. ‘The doctor freed my mother from the mental prison which she ended up in,’ the statement said.

Rare

Euthanasia for people with severe dementia is rare and accounted for just two cases in 2018. In that year, 2.4% of the 6,126 notifications of euthanasia involved someone with dementia.

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: Euthanasia allowed for dementia patients who gave prior consent: Supreme Court


Official sources in Dutch:
LiDO - Document met links
ECLI:NL:HR:2020:712, Hoge Raad, 19/04910
Arts mag gevolg geven aan schriftelijk verzoek tot verlenen euthanasie bij mensen met vergevorderde dementie

News coverage in Dutch:
Hoge Raad: arts mag euthanasie uitvoeren bij diepe dementie
Hoge Raad bevestigt: euthanasie bij zwaar demente vrouw was zorgvuldig
Hoge Raad: arts mag euthanasie uitvoeren bij diepe dementie
Hoge Raad: arts mag euthanasiewens patiënt met dementie interpreteren

 

[Palinurus]

Source (Dutch only): Arts wordt niet vervolgd in euthanasiezaak

NOS News - Interior - Today, 14:36

Doctor is not prosecuted in euthanasia case

A doctor who had accompanied an 84-year-old woman during her euthanasia in 2017 will not be prosecuted. That is the conclusion following a criminal investigation into this case. According to the Public Prosecutor's Office, there is insufficient evidence to blame the doctor for not having acted in accordance with the standards of due care. From now on, however, the doctor will have to explain her decision making a little better.

The woman in question was seriously ill. Physical conditions made it impossible for her to move around properly. She was also in pain because her medication did not work correctly and she suffered from all kinds of side effects. There was unbearable and hopeless suffering and the woman refused to be treated further. She asked her family doctor for euthanasia. She referred her to the Stichting Levenseindekliniek (SLK) [Expertise Center Euthanasia]. There, her case was discussed and twice a positive advice was given for euthanasia.

Other treatments

But the Regional Euthanasia Review Committees (RTE) thought otherwise. They felt that the doctor in question had not looked sufficiently at other treatment options. Perhaps there might have been other solutions to take the suffering away and the suffering would then not have been hopeless.

The criminal investigation later showed that there was no doubt about the diagnosis made by the doctor. Other treatments had been considered, but among the options available no real improvement of the symptoms could be expected.

No criminal accusation, but explaining better

The College of Procurators General has the opinion that there is no evidence for a criminal accusation. The doctor could indeed speak of hopeless and unbearable suffering and was allowed to conclude that there was no other solution to alleviate the suffering. However, the doctor was criticized because she had not made her motives sufficiently clear when the RTE started assessing her actions. It was only during the criminal investigation that there emerged more information which provided the necessary context.

The doctor should have motivated better at an earlier stage (also to non-medics) why she was convinced of the hopelessness and unbearableness of the patient's suffering. She should also have more clearly substantiated that there was no other way to alleviate the suffering. The doctor has been asked to improve on this in the future.


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

 

[Gwenllian]

Thanks a lot for keeping abreast of this very important topic, Palinurus. I think it is deeply troubling that they are pushing the envelope on euthanasia in these times where old people are already at such a disadvantage. But the fact that the Supreme Court came with this ruling while there is such a backlog of court-cases should tell us something. When I talked to my mother's GP last year he told me that many doctors wouldn't want to euthanise people with advanced dementia, but given the gross negligence of some doctors and nurses in New York City who are experimenting on patients which results in their death I am not so sure anymore. If no family are around to advocate for these people medical staff will be able to do God knows what.

 

[Palinurus]

Source (Dutch only): Vervolgde euthanasiearts doet voor het eerst haar verhaal: 'Ik zou het weer doen'

NewsHour - Interior - Today, 4:00 p.m.
Prosecuted euthanasia doctor tells her story for the first time: "I'd do it again"

Hans Kema en Coen Nij Bijvank
Editors

Marinou Arends never thought that performing a euthanasia in 2016 would bring her to court. Eventually, her case would even be heard by the highest Dutch court. In April, the Supreme Court dismissed her from prosecution. Now the retired specialist in geriatrics, who has remained anonymous all this time, tells her story in detail to NewsHour.

"I think it's important to show my side of the case," says Arends. "Not to defend myself, because that's what I did in court. But mainly because I think the euthanasia law is a very important law and because I want to provide transparency in the interest of that law".

Statement of intent

Seven weeks before her actual euthanasia, the 74-year-old demented woman who was eventually euthanized, ends up in the nursing home Florence in The Hague. Staying at home with her husband with whom she has been with for more than fifty years, is no longer possible. Coincidentally, there is a room available on doctor Arends' ward.

On the first day, Arends found out that the woman had a statement of intent in which she wrote that she would want to have euthanasia performed if she had to go to a nursing home because of dementia. She wants to never be admitted there.

"My first thought was 'I have to do something with that'," says Arends. "You have to take a euthanasia request seriously. I've always done that with other people who had a declaration of euthanasia and never wanted to end up in the nursing home."

Usually it turns out that euthanasia is no longer an issue, Arends says. "I once admitted a man whom I asked, 'Do you know why you're here, that you have dementia?´ That man said, 'Oh, yeah? I don't really suffer much from it. And the coffee's good, I like the view, I'm sitting here enjoying my newspaper. I'd like to do some more living.' Yeah, then of course euthanasia is out of the question."

"She was very unhappy all day"

But Arends sees that this woman does suffer. "When we drank tea, she usually began to complain at once how terrible it all was. That she couldn't do anything anymore. And that she was so tired. She was always unhappy, sad, rebellious, restless."

During conversations with other employees the woman also tells how miserable she feels, Arends is told. "Gradually you see that she's been miserable all day. And that's another word for suffering."

"
In the case of competency of will, a person must have a coherent opinion. And she lacked that.
Marinou Arends


Arends becomes more and more convinced that euthanasia is the right way to go. The husband, who has a mandate of authorization to make decisions about his wife, agrees with this view. But in her declaration of will the woman writes that she only wants euthanasia "when I myself think the time has come to do so" and "when I am still somewhat in control of my will".

However, because of her advanced dementia she is not anymore. Yet this does not stand in the way of euthanasia, according to Arends. "The law states that as a doctor you may and must interpret a declaration of will. The essence of the declaration had been met, I decided after lengthy consultation with colleagues."

"We reasoned this way: this is a handwritten statement from someone with a secondary vocational education, certainly not an academic and certainly not at a juridical level. She has tried, to the best of her knowledge and ability, to make clear what her wishes were."

Later, Arends is accused of going too far in her interpretation of the declaration of will. Moreover, she asked the woman three times whether she wanted to die, and received no affirmative answer.

Arends: "I don't know the exact answers verbatim anymore, but it was always something like: 'I believe that's going too far, dead, no, I don't know yet, I think'."

But, says Arends, the manner in which those words are said should also be taken into account by a doctor. "That's essential. All three times it was hesitant, with a wandering look of 'yes, that's difficult'. That's the crux with competency of will. Someone has to have a coherent, cohesive opinion. And that was completely lacking in this patient."

"I couldn't let her down"

In the end, Arends is swayed by the very serious suffering of the woman. "The choice was either to let her suffer severely for a long time or to give her the euthanasia she had desired on the basis of her core message in her declaration of will. If, being a doctor, I have the ability to stop suffering, then I cannot abandon her. That's how it felt."

“
Asking her if she wanted to die would only cause extra suffering.
Marinou Arends


Two independent doctors are also in agreement with her decision. On Friday morning, 22 April 2016, Arends starts preparations for euthanasia. The husband of the woman, her daughter and son-in-law are also present.

Arends decides not to ask the demented woman one last time whether she really wants to die. Later on, this decision would also be subject to much criticism from lawyers and colleagues.

"I did not ask that question because I knew that it would not lead to an answer that I could expect any direction from. Ask an incapacitated person and you will get an answer that comes straight from the emotion that exists at that very moment."

"And I knew she'd panic. I tested that a few weeks earlier, and then I saw what kind of suffering it caused her. A lot of anxiety, fear, frustration and anger. And, as a doctor, I then have the authority to omit that question."

Soporific in the coffee

To prevent the woman from becoming confused and panic-stricken during the administration of the lethal drugs, Arends first gives her coffee containing a soporific without the woman's knowledge.

Later on, critical doctors expressed themselves strongly about this. They think it is going too far to "sneaky" euthanize a demented woman. Arends: "This is concealed administration of medication, and this is permitted with the consent of the legal representative, in this case her husband and substitute her daughter. Both have given their full consent."

Arends doesn't see any other option. "How would you want to do it then? We couldn't let her say goodbye consciously. She didn't know she was going to die. That was no longer within her comprehension."

“
When I realized that even murder was an option, the image came to me of a prison cell.
Marinou Arends


After the euthanasia Arends sends all the details to an assessment committee, which evaluates the euthanasia as customary. "I thought I'd just explain this and then I´m done."

The medical disciplinary board reprimands her. On appeal, that's downgraded to a 'warning'. The court dismisses the doctor from all prosecution. The case eventually ends up before the Supreme Court.

The judges consider the question whether termination of life on an incapacitated, demented patient is allowed. "I never expected a trial, ever," says Arends. "I could account for any and all decisions. I was convinced that I had acted carefully, within the limits of the law."

"It's something bizarre. You're sitting on the bench, that doesn't match the vision you have as a doctor at all. The first time I realized that even murder was an option in court, the image came to me of a prison cell. That has such an incredible impact on a person."

Boundary case

But after the first court, the Supreme Court too dismisses Arends from all legal proceedings. Arends acted carefully, is the verdict. The Supreme Court thus established that a doctor may comply with a written request for euthanasia from someone who is no longer able to give confirmation due to advanced dementia.

It is a huge relief for Arends. In spite of the debilitating trial, she does not regret the euthanasia or her openness towards the review committee, which resulted in the trial. "I knew this was a complex case. But I stood firmly by it. Knowing what I knew then, I would have done it again. And knowing what I know now, where we are now after the Supreme Court ruling, I'm sure I'll do it again."

"I can imagine there are doctors who would consider this too much of a boundary case. I had to take that step without the patient's confirmation. And that was intense. But still the best decision."


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

 

[Michal]

Terrible stories.

 

[Palinurus]

Archiving links to news coverage about dr. Marinou Arends MD in English:

Doctor cleared of murder in euthanasia case says she would do it again - DutchNews.nl

Dutch MD Euthanized Dementia Patient Despite Being Told ‘No’ | National Review

Why I killed elderly woman who said 'no' three times, says euthanasia doctor cleared of murder

 

[Gary]

From Australia:

Victoria's first year of euthanasia sees lives end in peace and devastation

By Aisha Dow and Melissa Cunningham
June 18, 2020

Marita Scott's father Keith English accessed medication under Victoria's assisted dying laws after being diagnosed with terminal cancer. CREDIT:JOE ARMAO

Julian Bareuther and Keith English had very different deaths.

Mr English died peacefully surrounded by his family at his daughter Marita Scott’s home on a sunny, spring day last year. Mr Bareuther, however, took his own life after being ruled ineligible to access medication under Victoria's assisted dying laws.


A year to the day after the laws were introduced, the two men's cases show how vastly different people's experience of and access to euthanasia has been.

On the morning of Mr English's death, he read aloud letters he had written to each of his five children, nine grandchildren and his wife. The 96-year-old, who was in the final stages of terminal bowel cancer, went outside in his wheelchair to feel the sunshine on his face for the last time.


He died hours later after ingesting a cocktail of lethal drugs as Amazing Grace hummed softly in the background.
"The last thing I said to him was 'dad you go with so much love',” Ms Scott said. "Dad replied 'and I don’t want anything else'.”
Mr Bareuther, meanwhile, left a note politely asking those who discovered his body not to waste any of their time “on any silly theories of foul play” before taking his own life alone in his shared public housing block in St Kilda.
He wrote letters to two of his neighbours, thanking them for being good friends. They were pushed under the door of one of the nearby units.
The 68-year-old, had been dying of inoperable pancreatic cancer, but was denied access to the state’s assisted dying laws.

His lonely death in September last year was described as a “very sad tale” by a Victorian coroner this week.


Fifty two people with a terminal illness have died using lethal medication sanctioned by the state government since Victoria’s voluntary assisted dying laws were enacted on June 19 last year.
The laws allow access to a lethal substance for terminally-ill adults who have only about six months to live, or no longer than 12 months for those with a neurodegenerative diagnosis, and who meet other strict eligibility criteria such as being able to give informed consent.
On the first anniversary of the introduction of voluntary assisted dying, doctors say while some terminally-ill Victorians are dying swift, peaceful deaths under the laws, others are being blocked due to red tape, or dying after being unable to find a doctor willing to help them.

Figures obtained by The Age show more than 300 applications have been lodged by terminally ill Victorians since the state's landmark euthanasia laws came into force last year.
While it remains unclear how many of those applications have been successful, the figure is more than double the 135 people who applied for permits and were deemed eligible between June 19 and December last year.
Mr Bareuther was deemed ineligible for the voluntary assisted dying laws because, despite having lived in Australia for about 40 years after moving from the UK,he never became a citizen or permanent resident - a key eligibility requirement.

Keith English and his daughter Marita Scott.


Coroner Phillip Byrne was moved by the case and has asked whether it was possible to introduce “some level of discretion” in the assessment process.

“Although one can understand the rationale behind the denial of the [voluntary assisted dying] process to Mr Bareuther, I must say I have found it difficult not to feel sympathy for [his] plight,” he said, in findings handed down this week.
The coroner stopped short of issuing a formal recommendation.
Euthanasia advocate Rodney Syme said tragically Mr Bareuther's inability to access the laws was not unique.
"If there was one thing I could change immediately about the laws, it would be getting rid of the clause which says you have to be an Australian citizen," he said. "Many people have lived in Australia for decades after moving here as migrants, they call Australia home. But they're being denied access because they don't have a piece of paper."
Health Minister Jenny Mikakos said she was “deeply saddened” to learn of the circumstances of Mr Bareuther’s death, and had sympathy for the situation.

However, she added that the state’s euthanasia scheme was “the safest and most conservative model in the world and was developed after lengthy consultation and consideration to give people suffering with an incurable illness at the end of their lives another compassionate choice’”.
St Kilda GP Nick Carr has assisted 15 people with applications to access euthanasia. Most died with the lethal medication in hand, but without having used it.
“By the time they come to someone like myself, they’ve come to terms with the fact that they are going to die,” said Dr Carr, who sits on the board of Dying With Dignity Victoria.
Mr Bareuther was Dr Carr’s first patient to approach him about applying for the euthanasia drug.
He said like many terminally-ill patients he had seen, Mr Bareuther had been hugely relieved when he told him he could help coordinate his euthanasia application, and devastated when it emerged that he was not eligible.

“He was an Australian in every sense but a technical one, a previous taxpayer, a current Centrelink recipient and on the electoral roll,” Dr Carr wrote in his submission to the coroner.
“I personally was immensely distressed when I heard that Julian had killed himself. Here was a lonely man, dying of a horrible cancer, who sought my legitimate help.”
Among the many successful applications he’s been involved in, Dr Carr has also seen upsetting cases where it has taken people too long to fulfil documentation requirements, or they have been unable to get a second doctor to assess them, amid an ongoing shortage of medical practitioners willing to be involved.
He recalled a case of a prostate cancer patient in terrible pain who did not want to die alone, but encountered a series of hold-ups with his application, including finding a doctor to give a consulting opinion.
“He actually did die alone, exactly as he didn’t want to.”

Go Gentle Australia chief executive Kiki Paul said while Victoria's euthanasia laws were working as intended, some of the scheme's 68 safeguards were still creating barriers for eligible patients.
"There has been a relatively low number of doctors, particularly specialists, who have undertaken the mandatory training," Ms Paul said. "This has obvious ramifications for patients seeking a doctor who is qualified to guide them through the process. This reflects experience overseas where take-up of similar laws in their early years was small."
She urged the state government to embark on a education campaign, targeted at the medical community, outlining their rights and responsibilities in relation to assisted dying.
The Voluntary Assisted Dying Review Board, which assesses every application, will release its next report in July, which will reveal the number of people who have taken their own life using the laws in the first year.

Victoria's first year of euthanasia sees lives end in peace and devastation

On the first anniversary of the introduction of voluntary assisted dying, doctors say while some terminally ill Victorians are dying peaceful deaths under the laws, others are still being blocked from access.

www.smh.com.au

 

[Palinurus]

Thank you, Gary, for finding and sharing this information. It's a welcome addition from 'down under'.

From the article I gather that the first year of practice has revealed some serious shortcomings in the current law which should be mended when more information has become available to the lawmakers. It looks like one of the strictest regulations I've come across so far. Also, the shortage of doctors who have qualified by following the introductory mandatory training is a point of concern IMO. Nevertheless, over time a sort of habituation will be established which will make the process go more smoothly, I hope.

Luckily, there are also successful procedures mentioned -- but as the saying goes: all new beginnings are difficult.

 

[Palinurus]

Source: Submission of euthanasia at "completed life" law causing strife among coalition parties

Submission of euthanasia at "completed life" law causing strife among coalition parties

By Janene Pieters on Friday, 17 July 2020 - 16:50

D66 parliamentarian Pia Dijkstra submitted her legislative proposal to allow elderly people who feel they've come to the end of an complete life to ask for euthanasia, under strict conditions, to parliament on Friday. The submission of the controversial bill is causing some strife in the coalition of VVD, CDA, D66 and ChristenUnie, with especially the two Christian parties being vehemently against it.

Dijkstra planned to submit the bill much sooner than today, but the corona-virus crisis and a coalition agreement that a committee would first investigate whether the law was needed, delayed the process. The Van Wijngaarde committee submitted its report in January, after which some adjustments were made to the law. And then the corona-virus crisis hit.

Dijkstra found it "inappropriate" to submit her bill during the crisis, she said to newspaper AD. "The Netherlands was faced with a very serious crisis, which demanded the full attention of politicians, and therefore also our party."

The legislative proposal allows people over the age of 75 who feel that they have come to the end of their life and have a persistent wish to die to ask for euthanasia. "There is a group of elderly people who have finished their lives. They say: I go to sleep every night with the hope that I won't wake up again. I want to make euthanasia possible for that group under strict conditions," Dijkstra said to AD. "The problem is getting bigger now that the difference between your biological and you biographical life is increasing thanks to advancing medical conditions."

Christian parties CDA and ChristenUnie are vehemently against this bill. ChristenUnie leader Gert-Jan Segers is outraged that Dijkstra submitted it. "I find it extremely painful that at a time when older people feel extra vulnerable, D66 is submitting a proposal that we know will lead to increased anxiety in many older people," Segers said to the Telegraaf. "If corona has made anything clear to us, it is that real attention and good care make the difference in a human life."

CDA parliamentarian Harry van der Molen said to the Telegraaf: "As far as the CDA is concerned, there will be no completed life law, but we will tackle the causes of loneliness. Especially when people feel alone, abandoned or lost, they need attention or care."

Dijkstra told AD that she understands the Christian parties resistance to the law, but added that help with dying is not a problem for all Christians. She herself grew up in a Protestant, Mennonite home and studied theology for several years, she said. "With Mennonites, personal freedom to believe what you want is very important. I was baptized when I was 18 and I wrote my confession myself," she said. She drifted away from the church somewhat. "But I understand the thinking of a Gert-Jan Segers well. At the same time I think: just because you are against, you don't have to hinder others, do you?"

According to the D66 parliamentarian, critics' fears that this law will open the door to many elderly people taking their own lives are "not based on anything". "It is a small group, someone must be at least 75 years old. In addition, as a result of the Van Wijngaarden committee, I put extra emphasis in my law on the professional end-of-life counselor, who enters into discussions with people about their wish to die. He does not assess whether it is possible, but looks where that wish comes from and whether there are alternatives. I also pay more attention to the family and the general practitioner or treating doctor."

Coverage in Dutch:
ad.nl/politiek/br-pia-dijkstra-d66-dient-wet-voltooid-leven-in-zet-relatie-met-cda-en-cu-op-scherp~a7f8accb/
ad.nl/politiek/cu-reageert-op-d66-voorstel-voltooid-leven-buitengewoon-pijnlijk~ac77febf/
Wet ’voltooid leven’ van D66 zet coalitie op scherp

D66: alleen 75-plusser krijgt stervenshulp bij ‘voltooid leven’

 

[Palinurus]

Additional coverage published today: Euthanasia law proposed for healthy over-75s who feel their lives are complete - DutchNews.nl

Euthanasia law proposed for healthy over-75s who feel their lives are complete

July 19, 2020 - By Senay Boztas

A Dutch MP has submitted a long-awaited bill to offer healthy Dutch over-75s the right to ask for euthanasia.

Pia Dijkstra, medical ethics lead for D66, promised (in Dutch) to go forward with the controversial bill at the end of January, after government research (in Dutch) revealed that around 10,000 people over 55 have a serious death wish.

But the bill proposal, handed in on Friday, is likely to stoke conflict in the government because the two Christian parties in the coalition are radically opposed to it.

Free vote

Although the right to choose death is supported in theory (in Dutch) by Mark Rutte’s VVD, and a previous attempt at legislation in 2016 also had the support of the PvdA labor party and GroenLinks, it is unclear whether Dijkstra’s bill would win over the majority of MPs – which it would need, as it would be a free vote.

Her proposed law would mean healthy over-75s with a strong death wish for at least two months could have the assistance of an ‘end-of-life supervisor’ to die. But opponents of the law – including the KNMG Royal Dutch Medical Association – believe it could undermine the strict due care conditions of the existing euthanasia law, arguing that lonely and impoverished older people should have help, not the choice of an early death.

Benjamin Meijer, a spokesman for D66, told DutchNews.nl that his party had agreed with the coalition to wait for the publication of research into the group of older people who want help to die, and was then busy with the joint effort against the corona-virus.

Sensitive

‘Everyone in The Hague in politics was busy trying to battle this huge crisis,’ he said. ‘The target audience of this law is very different from those who died from corona but it is always a sensitive subject.’

He said that the proposal would now go to the Raad van State judicial advisory committee for review, a process which will take three to six months, before it can be refined and scheduled for debate and a vote. The hope is that it comes before parliament before the next general election in March 2021, he said.

‘These kinds of law proposals with very divisive subjects are not voted on according to party lines, but by free choice,’ added Meijer. ‘We can’t be in people’s heads to know if they have decided or would change their opinion.’

Dijstra has said that for D66 the law is ‘about having the choice at an advanced age, if people consider their lives complete, to be able to die with dignity, with careful help.’ It was inspired by a 2010 citizens’ initiative that gained 117,000 supporters.

Het gaat D66 om de keuze om op hoge leeftijd, als men eigen leven voltooid acht,
met zorgvuldige hulp waardig te kunnen sterven. En er zijn meer mensen geholpen met
de wet. Zij willen geruststelling dat ze in hun toekomst keuze hebben om waardig te kunnen sterven

D66 is concerned with the option of being able to die with dignity in old age with
careful assistance, if one considers one's own life to be complete. More people are being
helped with this law. They want reassurance that in their future they will have a choice to die with dignity.
— Pia Dijkstra (@piadijkstra) January 30, 2020 (translation DeepL)

‘Unacceptable’

But the ChristenUnie – a government party with five seats – has said the proposal is insensitively timed and completely unacceptable. Gert-Jan Segers, party leader, said in a post (in Dutch): ‘I find it extraordinarily painful that at a time when old people feel extra vulnerable, D66 submits a proposal that we know will cause many of them increased insecurity and worry,’ he said. ‘This is a path that the ChristenUnie absolutely will not tread.’

The CDA, the other Christian party in government with 17 seats, is also against the proposal, suggesting it could undermine existing euthanasia law. When the research on the unhappy older people was published, now-CDA leader and health minister Hugo de Jonge made an appeal to tackle loneliness and social problems. ‘This group’s death wish is serious and the report underlines the need for action,’ he wrote in a parliamentary briefing. ‘It is our task to make every effort to ensure that these people find the meaning of life and meaning in life again.’

However, the NVVE (in Dutch), a pro-euthanasia membership body which campaigned for the 2002 euthanasia law, has said it is pleased with Dijkstra’s proposal. ‘If the proposal becomes law, help to die from care staff other than doctors, such as psychologists, psychotherapists and nurses, would no longer be punishable,’ it said in a reaction online.

It added that many of this group who are ‘done with life’ do not qualify to request euthanasia under the existing law because they do not have severe medical complaints.

 

[Gwenllian]

RT has published a news item on this new Dutch draft law and revealed that babies who are very ill are also being euthanised. According to the Christian Legal Centre the lives of 15 to 20 babies are terminated in Holland every year. Listen to the proponent of 'right to die' euthanasia and how he manipulates language in order to condone this barbaric practice: babies "have help in shortening their life", ... babies who are seriously ill and are helped terminate their lives".

As babies can't ask for euthanasia, technically it isn't called euthanasia.

It's like listening to a pedophile who defends his 'attraction to minors'.

Apparently, euthanasia means something else in the Netherlands and Belgium:

In the Netherlands and Belgium, euthanasia is understood as "termination of life by a doctor at the request of a patient".[4] The Dutch law, however, does not use the term 'euthanasia' but includes the concept under the broader definition of "assisted suicide and termination of life on request".

This is what euthanasia seems to mean:

Euthanasia (from Greek: εὐθανασία; "good death": εὖ, eu; "well" or "good" + θάνατος, thanatos; "death") is the practice of intentionally ending a life to relieve pain and suffering.[1][2]

https://twitter.com/x/status/1286149036907536384

 

[Palinurus]

Thank you Mariama for finding and sharing this news item we otherwise would have missed. I went to the RT website in search of a written news article to copy/paste in here but couldn't find anything recent over there. So the twitter post seems to be the only source available at the moment.

As for the medical practice of terminating the life of critically ill newborns, my search yielded two results (Dutch only):

Arts mag dood ernstig zieke baby versnellen als sterven te lang duurt (behind paywall)

KNMG Standpunt Medische beslissingen rond het levenseinde bij pasgeborenen met zeer ernstige afwijkingen (PDF-file download link)

 

[Nienna]

Maybe it's just me, but it's starting to look like someone has found a way to get rid of the "undesirables" such as the elderly and people (starting at infant-age) who have "defects" and make it sound like it's a good thing for those who are being terminated. A form of eugenics. Or, maybe I'm just reading too much into this.