2019-66, due care criteria complied with

Straightforward notification, full report of findings, the independent physician must see the patient, island in the Caribbean part of the Netherlands.

The patient, a woman in her sixties, was diagnosed about six weeks before her death with a neurodegenerative disorder (a disease of the nervous system in which nerve cells die over a number of years). Her condition was incurable. She could only be treated palliatively. The patient’s suffering consisted of the loss of personal autonomy. In a short period of time she became fully dependent on care and found it increasingly difficult to communicate. She lost strength throughout her body. She was also suffering from the lack of any prospect of improvement in her situation and the knowledge that she would deteriorate further. She could no longer do the things that gave meaning to her life. She 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.

The physician consulted an independent physician who was a SCEN physician from the Netherlands. The independent physician conducted a video call with the patient. In his report, the physician explained his decision to consult an independent physician in the Netherlands. General practitioners on the islands in the Caribbean part of the Netherlands are few in number and know each other well. This means it is hard to avoid the appearance of a lack of independence. In the physician’s view, ensuring
his independence from the independent physician, and the fact that  this was the only way to have the patient assessed by a SCEN physician outweighed the desirability of the independent physician visiting the patient.

The independent physician concluded, partly on the basis of her video call with the patient, that the due care criteria had been met.

In respect of the deviation from the standard procedure as regards consulting
an independent physician, the committee observed that it was aware of the difficulty that could be encountered in the Caribbean part of the Netherlands in consulting an independent physician who was also a SCEN physician. It also noted that it can be difficult to avoid the appearance of dependence. The physician presented well-founded arguments for his decision to consult an independent physician in the Netherlands. The committee referred in this regard to the passage in the Euthanasia Code 2018 which expressly provides for the option of a discussion via an online video link between the independent physician and patient as an alternative to visiting the patient. The committee found that the physician had complied with the requirements of consulting at least one independent physician, who had seen and spoken to the patient via a video link.

The other due care criteria had also been fulfilled, in the committee’s view.