Voluntary and well-considered request
The physician must be satisfied that the patient’s request is voluntary and well-considered.
Patients must make request themselves
A request for euthanasia or assisted suicide must be made by the patient concerned. Though family members and often professional care staff are involved in the patient’s request, the law does not require their approval or consent. The patient’s wishes are paramount.
Decisional competence
The patient must be decisionally competent. This means that the patient is able to understand relevant information about their situation and prognosis, consider any alternatives, and assess the implications of their decision. It is not possible for a patient’s parents or legal representatives to make a request on the patient’s behalf.
Voluntary request
The patient’s request must be voluntary. This means that:
- the patient is capable of determining their own wishes (internal voluntariness). A request is not voluntary if, for example, it arises from a psychiatric or somatic disorder that affects the patient’s mental capacity;
- the patient must have made their wishes known without pressure or undue influence from others (external voluntariness).
Well-considered request
The patient’s request must be well-considered. This means that the patient has given the matter careful consideration on the basis of adequate information and a clear understanding of their illness.
Advance directive: not a statutory requirement
The Act does not require patients to put their request in writing, but an advance directive may provide extra clarity.
An oral request to the physician is sufficient unless the patient is no longer capable of expressing their wishes. An advance directive can replace an oral request in cases where at the moment when termination of life is being considered the patient is no longer capable of expressing their wishes. The patient must however have been decisionally competent when drawing up the directive. The physician must also check whether the other due care criteria have been met.
Request from a minor
Minors over the age of twelve may ask their physician to perform euthanasia. The Act distinguishes between two age categories:
- minors aged between 12 and 16: euthanasia may only be performed with the consent of the child’s parent(s) or guardian;
- minors aged 16 or 17: these patients may make an independent request but their parent(s) or guardian must be consulted in the decision-making process.
Terminating the lives of children under the age of twelve is regarded as termination without a request. It falls outside the scope of the Act.