2019-64, due care criteria complied with

Straightforward notification, full report of findings, intravenous infusion not flowing properly, emergency set past expiry date.

The patient, a woman in her seventies, was diagnosed with lung and pancreatic cancer six months before her death. A few months later she was found to have metastases in the liver. Her condition deteriorated rapidly in the final weeks before her death. The patient’s condition was incurable. She could only be treated palliatively. The patient had discussed euthanasia with her own general practitioner before. The latter was absent from the practice for some time, and the physician was acting as locum.

The physician started the euthanasia procedure by intravenously administering
2000 mg of thiopental (a substance that induces a coma). After having administered approximately 1300 mg, the physician observed that the IV cannula was no longer properly in place. The physician then halted the procedure and contacted the independent physician. The latter advised restarting the entire procedure from the beginning.

The physician had a new IV cannula inserted by a specialist team. When the physician proceeded to prepare the substances from the emergency set, it transpired that the expiry date of the substance to be used to induce a coma had passed. The physician contacted the pharmacist, who brought new ampoules. The physician then carried out the termination of life on request.

The committee noted the complicated course of the procedure. It found that, in the circumstances, the physician had carried out the termination of life with due medical care. The committee took account of the fact that after observing that the IV cannula was no longer properly in place, the physician had a specialist team insert a new IV cannula. When it became apparent that the expiry date of the coma-inducing substance in the emergency set had passed, she arranged for new substances to be brought. She subsequently carried out the termination of life in accordance with the KNMG/KNMP ‘Guidelines for the Practice of Euthanasia and Physician-Assisted Suicide’ of August 2012.

The other due care criteria had also been fulfilled, in the committee’s view.