Friday, February 17, 2017

Dutch nursing home death – more excuses, more killing

This article was originally published on January 29, 2017 on the HOPE Australia website.

Paul Russell
By Paul Russell, the director of HOPE Australia.

Once you create a situation at law where killing of another person is allowed in certain circumstances, not only will the circumstances in which such killing is endorsed or allowed change over time, but the boundaries, however originally drawn, will be entirely ineffective in providing moral, legal and ethical guidance and restraint.

In Belgium and The Netherlands in the thousands of euthanasia deaths since their laws came into being in 2002 few cases have ever been referred by the review systems to justice for further scrutiny. In Belgium that number is one; one case only. …

According to a multiplicity of reports, an un-named woman–an octogenarian living in a nursing home and experiencing dementia– was euthanized against her will. She had made a comment in her advanced directive that she would like euthanasia “when I myself find it the right time.”

The woman had been a resident in the nursing home for only seven weeks. During that time she was noted as being ‘frightened and angry’ wandering the halls of the facility at night and missing her family. This, the nursing home doctor concluded, meant that she was suffering unbearably. She assessed that the woman was no longer mentally competent and accepted that the written declaration she had made earlier in her advanced directive was an acceptable request for euthanasia.

The Dutch Law allows for a request for euthanasia in an advanced directive to be acted upon after the satisfaction of all the other qualifying criteria. The law considers such a written statement as a ‘well considered request for euthanasia’. How it can be known for certain that, at the time the request was written down, that the person understood fully the nature of their request is never explained.

Compounding the problem, the woman’s expression of intent in her directive was not clear and should not have been accepted as an advance request according to the Dutch Euthanasia Commission. She had written, concerning euthanasia, that she wanted it, “when I myself find it the right time.” At the very least, this expression suggests that the woman wanted to approach the matter when she thought it was appropriate, implying that her own capacity to make a contemporary decision was important to her. Paradoxically, the doctor’s determination that capacity had been lost should have rendered her statement null.

Various media reports point out that the woman was provided with a sedative in her coffee ‘to calm the woman down’. She was unaware that the sedative had been provided. The Trouw newspaper’s editorial discussed the issue of the provision of a pre-euthanasia sedative without the person’s knowledge, pointing to a recent case where a similar sedative was provided without consent in a bowl of apple sauce. They note that the Dutch Euthanasia Review Commission rightly considers such behavior as ‘deceptive’.

The Trouw editor concluded that the problem was really that the coffee-carried dose was too low. Why? Because the woman resisted when later the doctor moved to apply the lethal dose via syringe. The NLTimes described it this way:
‘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.’
According to the UK Mirror, this story came to light via a report prepared by a Dutch Coroner for review by the Dutch Euthanasia Regional Review Committee. The Mirror says that the woman had said clearly several times “I don’t want to die” in the days before her death.

The Euthanasia Review Committee is charged with reviewing the file and making a recommendation that would need to be endorsed by a second review committee.

The Mirror concludes:
“The committee concluded though the doctor had acted in good faith, she should have stopped when the patient resisted. 
“Committee spokesman Jacob Kohnstamm added he was in favour of the case going to court: “Not to punish the doctor, but to get judicial clarity over what powers a doctor has when it comes to the euthanasia of patients suffering from severe dementia.” 
“The committee’s recommendations are now reportedly being considered by prosecutors and health officials.” …
Euthanasia or assisted suicide laws create an exception to the laws prohibiting homicide if certain criteria are observed. They were not observed in these cases, therefore the exception should not be applied. In Holland it would seem that ‘good faith’ is enough to be let off with a little less than a slap on the wrist. But deciding what is and is not an act in ‘good faith’ is a tricky business. A wrongful death – even in ‘good faith’ is still a homicide and not simply a misdemeanor.

It may be that this situation is being used deliberately to further the current debate on euthanasia and dementia and euthanasia and ‘tired of life’. It may be that the doctor was lax in her application to the paperwork; a simple mistake. But it just may be about a death outside of the confines set by the parliament – deliberately or otherwise – a homicide.

Whatever the outcome, what is abundantly clear is that once we create legal excuses for killing there will be more excuses and more killing.


Dave Jackson said...

The Dutch know far, far more about Euthanasia than those outside their country. I find it disingenuous that some people attempt to besmirch the Dutch; their doctors, lawyers and politicians.

'Euthanasia' is simply one more option that a person can choose as their end-of-life approaches.

And for the 1% to 4% that elect Euthanasia, one reason might be their fear of Dysthanasia, where Medical Error is the 3rd highest [11%] cause of death.

Janine M. said...

Well, the rest of the world is watching and as more and more countries seem to be heading in the same direction, it is important to learn from the lessons that your country can teach. It has been the slippery slope (not that the beginning was ever the right place to be). The pro-euthanasia group pooh-pooh that argument but it indeed has happened in your country, in Belgium, and in those US States that allow it. The fact that only one case has been up for review in all of these years... The lack of oversight, the defence of the lack of oversight, indicates that euthanasia promoters know they could not withstand the scrutiny.
If it is so right, collect every speck of data you can and let the world scrutinize it.
I strongly doubt your hypothesis about medical error as the reason for choosing euthanasia, most people are unaware of those stats. Research has shown that people choose euthanasia most often because they fear suffering, and even more they fear being a burden to others. Shame on all of us for letting anyone think that! The bottom line is the world devalues certain lives: those with little autonomy, those with expensive diseases, those with cognitive impairments, those with physical disabilities. Let us hope that those euthanasia promoters do not find themselves one day in one of these groups with a change in opinion. Unfortunately, their revised views will most likely not be heard and no one will ever even know about it.

Gretch said...

You are either amazingly ill informed, or too young to really care. Eugenics is going full bore in the USA. You actually have to move in with your loved one to prevent it. Death panels are real. Professors at my university went to D.C. to set them up, and they have been incorporated into Obamacare along with the Liverpool Care Pathway. People are being systematically offed against their will. All the instances written up in Panzer's paper Lynching of the Elderly and Disabled are happening daily. Euthanasia is just eugenics with a polite name.