Euthanasia controversy: Doctor rebuked for helping uncertain woman die

For the first time in Dutch history a doctor in the Netherlands was reprimanded for giving euthanasia to a dementia patient while it was not conclusively established that euthanasia was what the woman wanted at that time, Trouw reports. The implementation of euthanasia was also traumatic, the Regional Review Committee concluded, according to the newspaper. 

The patient in question is a woman around the age of 80 years, suffering from dementia so far advanced that her husband could no longer cope with the care she needed. She had to be placed in a home. While the woman was still lucid she indicated that she definitely did not want to end up in a "home for demented elderly". She also stated in her will that she wanted euthanasia "when I myself find it the right time". 

In the nursing home the woman spent her days frightened and angry. She wandered the halls of the home at night and missed her family. After a few weeks the doctor at the home determined that the woman was suffering unbearably and is no longer mentally competent, but that the declaration she gave in her will justifies euthanasia. 

Euthanasia was preformed seven weeks after the woman was admitted into the nursing home. To calm the woman down, the nursing home doctor gave her a first dose of sedative in a cup of coffee. A second dose was injected into her. She seemed to fall asleep. But when the infusion was inserted she "pulled back", and while the doctor injected the euthanasia agent, she moved as if to get up. The doctor decided to continue while family members held the patient down. The woman died shortly afterwards.

The review committee determined that the woman's declaration in her will did not clearly state that she wanted to be euthanized after being admitted to a nursing home. The words "when I myself find it the right time" does not take into account a situation in which the woman was no longer mentally competent. The committee can understand how the doctor read it as a well-considered wish, but still feels that it was too broad an interpretation.

The committee also concluded that the doctor "crossed a line" by giving the woman the first dose of sedative secretly - hidden in a cup of coffee. And that the doctor should have stopped at the woman's movements at the end. Even though it is possible that the movements were purely physical reactions, it can not be certain. 

On other points, including the presence of hopeless and unbearable suffering and consulting other doctors on the matter, the committee found the doctor acted correctly and according to the rules. 

In January last year the Ministries of Security and Justice and Pubic Health gave the green light to allow euthanasia in advanced dementia patients, provided that the patient left a written request for euthanasia while he or she was still lucid. Despite this, euthanasia is hardly ever granted to patients with advanced dementia. 


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