Verdict (2016-85): Not Acted in Accordance with the Due Care Criteria

Verdict (2016-85): not acted in accordance with the due care criteria

Summary:termination of life of severely demented, incapacitated woman. Doctor could not unambiguously reach the conclusion on the existence of voluntary and well-considered request. Patient has never orally requested euthanasia and there was no clear written declaration of intent, as referred to in art. 2, second paragraph, of the law Review and termination of life on request and assisted suicide. Doctor has furthermore exceeded the limitby administration of Dormicum and by not ceasing the implementation of the termination of life when patient negatively reacted to the insertion of the drip and the administration of the euthanatica. In the implementation of the life termination, coercion, but even the pretence of coercion, must be prevented at all costs.

Considerations

In the absence of an oral request from the patient to the doctor to effective implementation of euthanasia and of a clear written declaration replacing it, the doctor could not, in the opinion of the Commission, unequivocally come to the conclusion that there was a voluntary and informed request for termination.

The Commission also takes the view that the doctor could come to the conclusion that the suffering of patient was hopeless and that there was no reasonable other solution for the situation in which she found herself. Alzheimer's disease is not curable. The Commission shall further take into account – among others – that the patient suffered less when her husband was with her, but that it was not possible for him to take care of her at home or be with her all the time in the nursing home. Patient had on several occasions in the past indicated to her GP that shedid not want to be admitted in a nursing home.

It has been found that the physician prior to the implementation of the termination has not discussed with the patient what she (RJ: the GP was female) intended to do. She has added Dormicum (midazolam) to the coffee of the patient and this medication also administered subcutaneously, to prevent the patient would resist to the administration of the euthanatica and to a struggle. It has been found that the patient during the insertion of the drip made a retreating movement and during the administration of thiopental sat up, after which she is held to prevent she would resist further.

In the view of the Commission the doctor with her approach has exceeded a limit. The Commission is of the view that the doctor should have stopped the implementation of the termination in order to consider the situation further and not had continued with the implementation while the patient had to be kept in a firm grip. The Commission also considers that forced implementation of termination of life, but even the pretence of coercion, should be avoided at all costs. Having regard to the foregoing, the Commission considers that cannot maintain the position that the termination of life has been carried out with due medical care.

4. JUDGMENT

The doctor has not acted in accordance with the due care criteria, referred to in article 2, paragraph 1, introductory wording and points (a) and (f) of the Law review and termination of life on request and assisted suicide.

The doctor does have acted in accordance with the other due care criteria referred to in article 2, paragraph 1, of the Law review and termination of life on request and assisted suicide.