2015-15, general practitioner, cancer, straightforward case
KEY POINTS: straightforward case, locum
As her general practitioner was temporarily absent, a patient whose suffering was severe asked a locum to perform euthanasia. The locum started the euthanasia process and contacted the SCEN physician. When the general practitioner returned, the patient made the euthanasia request to him, after which the general practitioner performed euthanasia.
Around six months before her death, the patient, a woman in her sixties, was diagnosed with pancreatic carcinoma that had metastasised to the lungs. Her condition was incurable. She could only be treated palliatively.
The patient’s suffering consisted of rapidly progressive, severe shortness of breath, despite the use of oxygen. The patient could only speak with difficulty and coughed frequently. She was exhausted. She also suffered from a fear of further deterioration and humiliation.
The patient 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.
There were no alternative ways to alleviate her suffering that were acceptable to her. The documents make it clear that the physician and the specialists gave her sufficient information about her situation and prognosis. The patient had discussed euthanasia with the physician before.
Eight days before her death, the patient asked a physician from the same practice, who was acting as her physician’s locum, to actually perform the procedure to terminate her life.
When her physician returned, a day before her death, the patient repeated her request to him. The next day she again repeated her request to her physician. The physician concluded that the request was voluntary and well-considered.
The locum consulted an independent SCEN physician on the physician’s behalf.
The independent physician visited the patient four days before the termination of life was performed, after she had been told about the patient’s situation by the locum and had examined the relevant medical records. In her report the independent physician gave a summary of the patient’s medical history and the nature of her suffering. The independent physician concluded, partly on the basis of her interview with the patient, that the due care criteria had been met.
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 examined retrospectively whether the physician had acted in accordance with the statutory due care criteria laid down in section 2 of the Act. The committee then decided whether the due care criteria had been complied with in the light of prevailing medical opinion and standards of medical ethics.
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 her suffering was unbearable, with no prospect of improvement. The physician gave the patient sufficient information about her situation and 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 committee found that the physician had acted in accordance with the statutory due care criteria laid down in section 2 (1) of the Act.