2016-44, general practitioner, combination of disorders, unbearable suffering without prospect of improvement

KEY POINT: unbearable suffering caused by impaired vision

The patient, a man in his eighties, had suffered for 10 years from macular degeneration (which causes cells in the centre of the retina to die) in both eyes, which caused his eyesight to deteriorate. Around the same time, an obstructed blood vessel in the retina caused blindness in his right eye. Six months before his death, his left eye deteriorated so much, despite the start of treatment, that he was no longer able to read, even using aids.
In addition to these eyesight problems, he was uncertain when walking, which was aggravated by his near-blindness. In recent years he had become unwell and fallen several times.

Because he had become almost totally blind, the patient could no longer read (which was extremely important to him) or pursue his other hobbies. He was suffering from the loss of these activities, which were essential to him. He also suffered from the loss of self-reliance caused by his impaired vision, and the fact that he knew that there was no prospect of improvement whatsoever.

The patient, who had always had a wide range of interests and a great intellectual appetite, experienced his suffering as unbearable.

The committee found that the physician had plausibly argued that he was reasonably able to conclude that the patient’s suffering was unbearable to him and without prospect of improvement, and that it was unlikely that optical aids and possibly surgery would enable him to read again. The other due care criteria were also fulfilled.