First ever trial against euthanasia doctor starts in Den Haag

A doctor is standing trial in the court of The Hague on Monday for performing euthanasia on a patient with advanced dementia. While doctors have been reprimanded or warned by the disciplinary court in the past, this is the first time since the euthanasia law was implemented in 2002 that the Public Prosecutor considered it necessary to bring someone to criminal court, NOS reports.

This case revolves the death of a 74-year-old woman with advanced dementia. While she was still lucid, the woman made a declaration that she did not want to end up in a nursing home and wanted euthanasia when she considered it was the "right time". In addition to the ambiguity of the "right time", the woman also gave alternating signals once in the nursing home. "At certain times she indicated that she did not want to die", the Prosecutor said. The doctor eventually performed euthanasia "in close consultation with the family".

Euthanasia for patients with advanced dementia is rare. Last year it happened twice, compared to the over 4 thousand euthanasia requests granted for patients with cancer. In 2016 the Ministry of Public Health updated its "guide" to euthanasia to allow people with dementia to request euthanasia while they are still lucid enough to do so. But the issue of patients changing their minds while in the advanced states of dementia is not specifically addressed. 

In this case, the Public Prosecutor does not doubt the doctor's good intentions, but thinks that "this doctor should have had a more explicit conversation with the dementia patient". The law does not provide clarity on this point, and that is part of the reason that the matter is going to court, a spokesperson for the Public Prosecution Service said to NOS. "Because that clarity must be there for doctors: how far does your responsibility extend." This case will be important for legal precedents, against the background of the social debate on dementia, euthanasia and the aging population, the Prosecution spokesperson said. 

Jaap Sijmons, professor of health law at the Utrecht University, agrees that this will be an important case, especially given that the aging population means that more and more people will get dementia. This case will set some guidelines, he believes. "So that we know a little more where we stand", he said to NOS. "The law does not provide for euthanasia in patients with dementia because it requires a patient to make a voluntary and well-considered euthanasia request. If you have dementia, you have passed the stage where you can do so." 

Sijmons does not think the Prosecutor is after punishment for this doctor. "I think this is a test process and you simply need a suspect for that', he said to the broadcaster. "The judge must rule on this. If you want to enforce the law, the norm must be clear. And if you want to dismiss a case too."

The Termination of Life on Request and Assistance with Suicide Act, shortly called the Euthanasia Act, was implemented in the Netherlands in April 2002. The law caused a great deal of commotion, especially abroad where it was called legalized murder by some international press. Since then Belgium and the America states of Montana, Oregon and Washington also  implemented euthanasia laws. Elsewhere in the world, euthanasia is still illegal.