Report: Euthanasia without consent of Dutch woman with dementia

Richard Egan wrote the following summary of the report from the Regional Disciplinary Court for Healthcare that was issued in the Hague on July 24, 2018.

By Richard Egan (with the Australian Care Alliance)

In Case 2016-85 the Review Committees found that a doctor had not acted with due diligence in administering euthanasia to a woman with Alzheimer’s disease. The woman had made a general reference in a living will to wanting euthanasia at the “right time”. At the time the doctor euthanased her she was incompetent to voluntarily request it.

Article: Netherlands review committee examined case of euthanasia without request of woman with dementia.

The doctor put medication in her coffee to reduce her consciousness deliberately so as to avoid her resisting being given drugs by injection. Nonetheless she physically struggled against the administration of an intravenous lethal injection. She was physically restrained by family members while the doctor completed the administration of the lethal drugs.[1]

A criminal investigation into this case commenced in September 2017 but has not yet concluded.[2]

Article: Dutch Minister of Health comments on forced euthanasia.

On June 13, 2018 the Regional Disciplinary Court for Healthcare in The Hague considered a complaint against the doctor brought by the Inspectorate for Health Care and Youth. The decision was published on July 24, 2018.[3] The Court found that the written declaration of intent was not sufficiently clear to justify euthanasia in this case. It also found that the doctor should have tried to discuss the execution of euthanasia with the patient beforehand.

“In view of the irreversibility of termination of life and the ethical aspects connected with the deliberate ending of the life of a fellow human being, a written euthanasia declaration must be unambiguous, not needing any further interpretation.”

The Court did not completely rule out that ambiguities in a written declaration of intent could be removed (even in the case of a demented patient) if a patient is later unambiguous, consistent and tenacious (verbally or non-verbally) in his statements about wanting death. However, with this patient this was not the case because she sometimes said she wanted to die and sometimes not. Despite its finding that the doctor had seriously breached the requirements for euthanasia it only imposed a reprimand on the doctor. This was said to be sufficient because the doctor had cooperated in the process (she actually tried to get the complaint dismissed on procedural grounds) and also because a criminal investigation was still under way.

Article: Dutch doctor reprimanded for euthanasia without consent of woman with dementia who resisted.

[1] Regionale Toetsingscommissies Euthanasie, Jaarverslag 2016, p. 54-58 https://www.euthanasiecommissie.nl/binaries/euthanasiecommissie/documenten/jaarverslagen/2016/april/12/jaarverslag-2016/RTE_jaarverslag2016.pdf

[2] https://www.om.nl/onderwerpen/euthanasie/beslissingen-college/@100430/investigation-into/

[3] https://www.tuchtcollege-gezondheidszorg.nl/binaries/tuchtcolleges-gezondheidszorg/documenten/publicaties/documentatie-procedures/uitspraken/uitspraken-van-persberichten/beslissing-euthanasie-bij-dementie/2018-033bes.pdf