2018-116, due care criteria complied with

Publication | 01-01-2018

The patient, a man in his sixties, was diagnosed with a malignant tumour in the parietal pleura the year before his death. His condition was incurable. He could only be treated palliatively (care aimed at improving the patient’s quality of life).

The patient’s suffering consisted of pain, particularly in the abdomen and head, nausea, vomiting, inability to eat and extreme difficulty drinking. He had difficulty swallowing and was emaciated. He also suffered from constipation, dizziness, debilitation, fatigue and reduced mobility. The patient was suffering from the lack of any prospect of improvement and the likelihood of further physical deterioration leading to complete dependence on care.

He experienced his suffering as unbearable. The physician was satisfied that this suffering was unbearable to the patient and with no prospect of improvement according to prevailing medical opinion. There were no alternative ways to alleviate his suffering that were acceptable to the patient. The documents made it clear that the physician and the specialists had given him sufficient information about his situation and prognosis.

The patient had discussed euthanasia with the physician before. Three days before his death, the patient asked the physician to actually perform the procedure to terminate his life. The patient later repeated his request. The physician concluded that the request was voluntary and well considered.

The physician consulted an independent physician who was also a SCEN physician. The independent physician saw the patient two days before the termination of life was performed, after he had been informed of the patient’s situation by the physician and had examined his medical records. In his report the independent physician gave a summary of the patient’s medical history and the nature of his suffering. The independent physician concluded, partly on the basis of his interview with the patient, that the due care criteria had been complied with.

The physician performed the termination of life on request using the method, substances and dosage recommended in the KNMG/KNMP’s Guideline ‘Performing euthanasia and assisted suicide procedures’ of August 2012.

The committee examines retrospectively whether the physician acted in accordance with the statutory due care criteria laid down in section 2 of the Act. In view of the above facts and circumstances, the committee found that the physician could be satisfied that the patient’s request was voluntary and well considered and that his suffering was unbearable, with no prospect of improvement.

The physician informed the patient sufficiently about his situation and his prognosis. Together, the physician and the patient could be satisfied that there was no reasonable alternative in the patient’s situation. The physician consulted at least one other, independent physician, who saw the patient and gave a written opinion on whether the due care criteria had been complied with. The physician performed the euthanasia with due medical care.

The physician acted in accordance with the due care criteria laid down in section 2 (1) of the Act.