2015-56, general practitioner, cancer, independent assessment

KEY POINTS: simultaneous performance of euthanasia on a couple, independent physician’s opinion.

The patient was suffering from metastasised pulmonary carcinoma. He asked his physician to perform euthanasia, a few days after his wife had asked her physician for euthanasia. Both physicians consulted the same independent physician, who spoke with both patients together. The physicians and the independent physician stated that they had discussed this extensively beforehand. The committee found that if, after consideration, it has been decided to consult one independent physician for both partners, the independent physician must in principle speak with each partner separately. In this case, however, the committee had no doubts about the independent judgment of the independent physician.

More than a year before his death, the patient, a man in his seventies, was diagnosed with metastasised pulmonary carcinoma. His condition was incurable. Nine days before his death, the patient asked the physician to actually perform the procedure to terminate his life. A few days earlier, the patient’s wife had asked her physician to actually perform the procedure to terminate her life.

The physician consulted an independent physician who was also a SCEN physician. The independent physician saw the patient and his wife five days before the termination of life was performed, after he had been told about the patient’s situation by the physician and had examined his medical records. He did not speak with the patient in private. The independent physician concluded, partly on the basis of his interview with the patient, that the due care criteria had been complied with.

The physicians who performed euthanasia and the independent physician stated in a written explanation that they discussed this special situation extensively prior to the procedure. Both patients were terminally ill and their life expectancy was a few weeks at most. Both the physicians who performed euthanasia, who had each gone through the process with their own patient, were satisfied that the patients had decided independently from each other to request euthanasia. There were no doubts whatsoever that their suffering was unbearable and that their requests were voluntary and well-considered. During his visit,  the independent physician had always faced the person who was speaking and felt that he had had two conversations. The  independent physician was satisfied that his judgment was independent.

In the event of simultaneous euthanasia requests by a couple, the committee deems it important for the physician(s) to consider carefully whether it is preferable to consult one independent physician for both partners or a separate independent physician for each. If, after deliberation, the conclusion is that one independent physician will be asked to assess both requests, that physician will have to be extra alert to the question of whether he is able to form an independent judgment in both cases.

The committee finds that in such cases the independent physician should in principle speak to each partner separately, to assess whether the request was made under any pressure. There can be cases, however, in which speaking to the partners separately is not necessarily essential.

On the basis of the reports of the physician and the independent physician, and the rest of the file, the committee had no doubts (in both cases) about the independent judgment of the independent physician concerning the due care criteria.