October 6, 2022

Informed consent in Netherlands: euthanasia

A 64-year-old Dutch woman with dementia was euthanased earlier in March, it has been revealed. According to the Dutch daily De Volkskrant, it was the first time that a person in an advanced stage of dementia had been euthanased.

A 64-year-old Dutch woman with dementia was euthanased earlier in March, it has been revealed. According to the Dutch daily De Volkskrant, it was the first time that a person in an advanced stage of dementia had been euthanased.

Although Dutch euthanasia legislation provides for this, doctors still have been reluctant to euthanase demented patients, at least officially. They are supposed to be satisfied that the patient has made “a voluntary and carefully considered request”, which a demented person cannot do. However, the law also allows advance directives to be taken into account if patients are no longer competent to express themselves.

Earlier this year, the Royal Dutch Medical Association (KNMG) issued a position paper which declared quite firmly that “the Euthanasia Law expressly also applies to patients with dementia and psychological illnesses”.

In this landmark case, before her dementia developed the woman had repeatedly said that she wanted euthanasia and she had left a “living will”. Her husband and children supported the idea. However, once she slipped into dementia, she became incapable of expressing a wish to die. Initially one doctor refused to approve euthanasia (two are required) because he could not be sure that the request was voluntary and carefully considered.

The case was exceptional, even in the Netherlands, and all five regional euthanasia review committees studied the request. They all approved it.

As in other countries, the Netherlands is facing a dementia tsunami. It is estimated that 500,000 people will have dementia in 2050. The death of this unnamed woman probably foreshadows many more. ~  De Volkskrant, Nov 9; Radio Netherlands, Nov 9

Michael Cook
euthanasia
Netherlands