Doctors euthanizing a patient with severe dementia may introduce a sedative into their food or drink if they are concerned that they will become “disturbed, agitated or aggressive”, due to a change in codes of practice in the Netherlands.
The euthanasia review committee updated its guidance in response to the case of a former nursing home doctor, Marinou Arends, who was prosecuted for murder and acquitted after putting a sedative in her 74-year-old patient’s coffee. give him a lethal injection. .
Arends received a written reprimand from the Dutch medical board for acting on the basis of two “advance directives” in which the patient only said that she wanted to die when she felt the time was right.
But in April, the supreme court ruled that no laws had been violated and overruled the medical board’s decision, ruling that if a patient can no longer give consent, a doctor need not interpret an advance directive literally if the circumstances do not. they do. match the eventual scenario.
Responding to the court, Jacob Kohnstamm, chairman of the euthanasia review committee, said his body needed to update its code for physicians involved in euthanasia.
The new code says that in cases where a patient has advanced dementia, “it is not necessary for the doctor to agree with the patient when or how euthanasia will be administered.”
Kohnstamm said: “Doctors now have less to worry about putting their necks in a noose with euthanasia. They need less fear of justice. Or for the review committee. “
The decision has not been unanimously accepted. When the 2018 case was first made public, 220 doctors put their name in an advertisement condemning any doctor who “secretly” sedated patients who were helped to die.
Bert Keizer, manager of a nursing home, told the Volkskrant newspaper that he was opposed to the changes, but that the clarity was welcome. He said, “This is not going to take off. There are very few doctors who want to do this, but it is good for those who do to have this clearly written on paper. “
Since 2002, doctors have been able to euthanize adults in the Netherlands in cases where it is considered a voluntary and well-considered request in the context of excruciating suffering for which there is no prospect of improvement or alternative remedy.
Last year there were 6,361 cases of euthanasia in the Netherlands, a little over 4% of the country’s total deaths. Of these, 91% were in cases of terminal illness. The rest of the cases involved a serious psychiatric illness, including dementia.
This month, the Dutch government said it would change regulations to allow doctors to euthanize terminally ill children between the ages of one and 12, after months of debate within the ruling coalition government.
Health Minister Hugo de Jonge said that a change in regulations was necessary to help “a small group of terminally ill children who are dying without hope and in unbearable suffering.”
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