2015-59, general practitioner, cancer, no reasonable alternative, voluntary and well-considered request, unbearable suffering without prospect of improvement

KEY POINT: decisional competence in relation to the euthanasia request, which was made by a minor in the 16-18 age group (section 2 (3) of the Act)

The patient was diagnosed for a second time with acute myeloid leukaemia. Following the first diagnosis, she had received a stem cell transplant. She did not want to undergo this treatment again. The patient was suffering unbearably from pain, fatigue, nausea and the loss of control over her life. She requested euthanasia.
The committee found that it was clear that the patient was decisionally competent in relation to her euthanasia request. Her parents had been involved in the decision. This was in accordance with section 2 (3) of the Act, concerning minors between 16 and 18 years of age.

In spring 2015, the patient, a woman aged between 16 and 18, was diagnosed for the second time with acute myeloid leukaemia. In 2013, the patient had also had acute myeloid leukaemia and had received a stem cell transplant.

In view of the very small chance of success and the severe impact of this treatment, the patient declined the opportunity to undergo another stem cell transplant.

The patient’s suffering consisted of pain, fatigue and nausea. Above all, however, she was suffering from the loss of control over her life. Now that it was clear that she only had weeks to live, she wanted to determine how that period would be concluded.

Two days before her death, the patient asked the physician to actually perform the procedure to terminate her life.

The committee noted the following with regard to the patient’s request. Section 2 (3) of the Act states that if the patient is a minor aged between 16 and 18 and is deemed to be capable of making a reasonable appraisal of his own interests, the physician may comply with a request made by the patient to terminate his life or provide assistance with suicide, after the parent or parents who have responsibility for him, or else his guardian, has or have been consulted.

The committee found that in the case under review the physician could comply with the request. It was clear from the information provided by the physician that the patient was decisionally competent in relation to her euthanasia request.
Her parents had been involved in the decision concerning her request.