New York Times
LONDON — A court in the Netherlands on Wednesday acquitted a doctor who had been accused of unlawful euthanasia for administering a lethal injection to a patient with dementia, a case that raised questions about the clarity of the country’s law in such circumstances.
The patient, 74, who has not been publicly identified, had asked in writing for doctors to end her life if she had to be admitted to a nursing home, and if she thought the time was right. But, when she entered the home, incapacitated, she appeared to have changed her mind, giving “mixed signals,” about her intentions, prosecutors said. . . . [Full text]
The number of euthanasia requests submitted to the End of Life Clinic in The Hague this year increased by 15 percent compared to last year. According to the clinic, officially called the Euthanasia Expertise Center from Wednesday, the increase is due to the judiciary’s harsher attitude towards euthanasia, the Volkskrant reports.
The clinic was established in 2012 as a safety net for patients whose own doctor will not listen to their request for euthanasia. A few years ago the number of euthanasia requests to the clinic seemed to stabilize at around 210 a month. . . . [Full text]
Marike E de Boer, Marja F I A Depla, Marjolein den Breejen, Pauline Slottje, Bregje D Onwuteaka-Philipsen, Cees M P M Hertogh
The majority of Dutch physicians feel pressure when dealing with a request for euthanasia or physician-assisted suicide (EAS). This study aimed to explore the content of this pressure as experienced by general practitioners (GP). We conducted semistructured in-depth interviews with 15 Dutch GPs, focusing on actual cases. The interviews were transcribed and analysed with use of the framework method. Six categories of pressure GPs experienced in dealing with EAS requests were revealed: (1) emotional blackmail, (2) control and direction by others, (3) doubts about fulfilling the criteria, (4) counterpressure by patient’s relatives, (5) time pressure around referred patients and (6) organisational pressure. We conclude that the pressure can be attributable to the patient–physician relationship and/or the relationship between the physician and the patient’s relative(s), the inherent complexity of the decision itself and the circumstances under which the decision has to be made. To prevent physicians to cross their personal boundaries in dealing with EAS request all these different sources of pressure will have to be taken into account.
de Boer ME, Depla MFIA, den Breejen M, Slottje P, Onwuteaka-Philipsen BD, Hertogh CMPM. Pressure in dealing with requests for euthanasia or assisted suicide. Experiences of general practitioners. J Med Ethics. 2019 Jul;45(7):425-429. doi: 10.1136/medethics-2018-105120. Epub 2019 May 15.
Christopher de Bellaigue
Last year a Dutch doctor called Bert Keizer was summoned to the house of a man dying of lung cancer, in order to end his life. . . . Keizer is one of around 60 physicians on the books of the Levenseindekliniek, or End of Life Clinic, which matches doctors willing to perform euthanasia with patients seeking an end to their lives, and which was responsible for the euthanasia of some 750 people in 2017. . . [Full text]
A 42-year-old married woman with three children was referred to our department for treatment of treatment-resistant depression. Pharmacotherapy, psychotherapy, and ECT were unsuccessful. We applied deep brain stimulation, which was partially effective and reduced depressive symptoms by 30%, but the patient still suffered. During our struggle to find optimal deep brain stimulation parameters in the course of treatment, the patient requested that her general physician provide euthanasia. Following guidelines in the Netherlands, our team was consulted, but we disapproved because her suffering was not prospectless and there still were treatment options with deep brain stimulation. Although we had treated her intensively for 2 years, our advice was disregarded. Eight weeks later we received the obituary of the patient.
Denys D. Is Euthanasia Psychiatric Treatment? The Struggle With Death on Request in the Netherlands. Am J Psychiatry. 2018 Sep 1;175(9):822-823. doi: 10.1176/appi.ajp.2018.18060725.