Psychiatrist reprimanded for sloppy handling of euthanasia requests

A psychiatrist who handles euthanasia requests has been reprimanded for not acting with due care in two cases. The Regional Disciplinary Court for Healthcare in Amsterdam ruled that the healthcare provider did not follow the correct procedure. In the first case, she disregarded a second opinion; in the second one, she did not ask for one.

In order to proceed with euthanasia, a doctor must meet all due care criteria laid down by law. For example, a patient must be mentally competent to make the decision to die. Psychiatrists also use another guideline, which states that with euthanasia requests, they should always ask for a second opinion from a fellow psychiatrist who knows the patient's mental disorder.

The reprimanded psychiatrist is accused of ignoring a colleague’s second opinion in one case. That fellow psychiatrist found that the patient involved was not mentally competent, among other things, “because the reason for wanting to die lies in a psychotic conviction.” There were also further treatment options available for the patient, the colleague said.

The psychiatrist did continue to treat her patient. But when that process was completed, she took up the request for euthanasia again. After consulting her team and another expert, she concluded that the patient was mentally competent. When she represented this to the colleague psychiatrist, who previously ruled that the patient was not mentally competent, the colleague did not understand her conclusions. According to the disciplinary committee, the reprimanded psychiatrists did not properly substantiate why she stuck to her own opinion.

In the second case, the psychiatrist did not ask for a second opinion at all. She herself also admitted that this was contrary to the guideline used in psychiatry “and was therefore incorrect.”

The disciplinary committee said it considered the "complexity of the matter" with which the psychiatrist had to deal when imposing the reprimand. The Board also said that it had not been shown that patient safety had been compromised. A reprimand means that the disciplinary committee condemns the behavior of a healthcare provider but that the person can continue to practice their profession.