2016-96, general practitioner, multiple geriatric syndromes, unbearable suffering without prospect of improvement

KEY POINT: unbearable suffering cause by multiple geriatric syndromes

The patient, a woman in her eighties, had received a full hip replacement and two knee replacements, as a result of osteoarthritis (wear and tear of the joints). She also suffered from rheumatoid arthritis (an auto-immune disease which causes inflammation of the joints) and macular degeneration (which causes cells in the centre of the retina to die).

In the last year before her death, the patient’s condition deteriorated sharply. Her mobility continued to decline and she always felt cold. She suffered from pains in her knee, while her very limited eyesight and reduced mobility confined her to a chair, and she was able to do less and less. She became increasingly dependent on other people for her care and could no longer watch television, read or write.

In the year before her death, she hardly left the house. Although she received help in the daytime from family and professional carers, she was often home alone. On those occasions she was anxious and afraid of falling. The patient did not want to move into a nursing home, as she had previously had bad experiences there following surgery. She felt her life to be futile and she knew that her health would only deteriorate further. She experienced her suffering as unbearable.

The physician was satisfied that this suffering was unbearable to her and with no prospect of improvement according to prevailing medical opinion.

The committee found that the physician had acted in accordance with the due care criteria.