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The regional disciplinary body for health care in The Hague has reprimanded a retirement home doctor for the reckless performance of euthanasia in a seriously insane woman. The woman's declaration of euthanasia was too imprecise to justify euthanasia, according to the Disciplinary Tribunal
. The attending physician should not forget that the patient would be put to death on the day of euthanasia. That the doctor has had a sleeping pill through the demented woman's coffee to calm her, she should also try to consult the patient.
The verdict of the Disciplinary Court was on a number of very principled points. The Disciplinary Judge clarified that there is "no room for interpretation" in the case of an unclear euthanasia request. In this case, the woman, a former kindergarten teacher, had described in her euthanasia statement that she wanted to die if she ended up in a retirement home. But the same statement states that she wanted euthanasia if she "sees herself as the time for that" and only when she asks for it herself.
The retirement home doctor weighed the fact that the woman did not want to end up in a heavier home than the passages. on this subject, the patient wanted to ask him himself. It was clear to the retirement home doctor that the woman was suffering terribly in the retirement home. She wandered at night, pounding the walls, calling her husband. She slapped, scratched and bit the staff sometimes.
That's how this woman did not want to live, decided the doctor. It was an "unbearable" and "hopeless" suffering – a motive for euthanasia as described in the law on euthanasia. According to the doctor, the communication of the advance directive with the patient was no longer possible because she was so mad that she no longer understood what euthanasia involved.
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See also NRC reconstruction for this case
Warning to Society
But it is not permissible to weigh a poorly prepared request for euthanasia in such a demented patient, the Disciplinary Judge has precise. Because it was indeed no longer possible to know what the former teacher meant: did she want euthanasia when she entered a retirement home, or only when she asked for it herself?
This put the doctor in trouble with another condition of euthanasia that the law states, namely that he must act on a "voluntary and thoughtful" request. Renée Dozy explained at the end that the statement in this regard is intended to warn society: "A statement of euthanasia must be crystal clear."
The 2002 Euthanasia Act authorizes the euthanasia of people with severe dementia. This is possible only if they have written a clear written statement of intent. But, as the disciplinary judge pointed out, one must always listen to a mad patient. On the other hand, it can also happen that a demented patient who has clearly described in a statement of intent when he wants to die, wants to get rid of it. "A demented patient does not lose the right to dispose of his own life," said the judge
. This is also the reason why the Disciplinary Judge criticizes the way the family doctor practiced euthanasia. It was not told to the patient that she was going to receive euthanasia that day, according to the doctor, because that would only make her feel uncomfortable and that she would be sick. she could not understand what was happening anyway. The judgment shows that a doctor should always try to explain to a patient what is going on. If the person is in trouble, however demented, the euthanasia must be aborted.
The best intentions
A reprimand is one of the lighter punishments that a disciplinary court may impose. The Disciplinary Judge is of the opinion that the retirement home doctor, now retired, has acted with the best intentions. She maintained good contacts with the family who attended euthanasia and consulted with several experts and other doctors to make a decision.
Judgment has great social significance. The prosecution is also conducting a criminal investigation into this case, which has recently become a symbol of the medical-ethical discussion on euthanasia in advanced dementia. The Regional Euthanasia Review Committee found the practice of the caregiver "negligent"
including the movement "Not secretly in dementia" protest of more than 200 doctors who made it clear that They did not want to practice euthanasia in advanced dementia. people on the basis of a written statement. Earlier this year, an ethicist joined the regional euthanasia committees because she felt that people with dementia were too easily euthanized
At the time of dementia
Mirna Oosting, attorney at the Health and Youth Inspection next "important to society". Steven Pleiter, director of the end-of-life clinic (which deals with complex applications for euthanasia) said that there are "two lessons" to be learned from the statement: "The consent statement must be clear . And it is better to be at the moment with dementia, because people who are seriously insane do not often get euthanasia. "
Last year, 166 people with dementia had euthanasia, of which three were already so sick that they could not do it anymore. has already been produced twice before There is no comparable case known to the Disciplinary Tribunal Evaluation committees have assessed the actions of the physician in both cases where a deeply insane patient has been euthanized both as "cautious" this year.
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