Committee procedures

Notification by physician

Any physician who has performed euthanasia or assisted in suicide must notify the municipal pathologist of their actions, since these are not natural causes of death. The municipal pathologist forwards the notification to the review committee.

Review of the actions of the notifying physician

The committees review the actions of the physician in light of the due care criteria. They first consider the written information accompanying the notification, including a substantiated report from the notifying physician and the report of the independent physician consulted in this case.

The review committee may ask the physician to provide supplementary information either orally or in writing if this is necessary to make a proper assessment. Well-substantiated reports from both the physician and the independent physician can eliminate the need to ask for additional information.

Findings

The findings of the review committee may be: 

• due care criteria complied with; or
• due care criteria not complied with; or
• committee not competent to review the case.

Review period

The committee informs the physician of its findings in writing within six weeks of receiving the notification and accompanying documents. This period can be extended once for another six weeks.

Procedure

If the committee finds that the due care criteria have been complied with, the review procedure ends. The case has then been disposed of de facto. However, if it decides that the physician did not comply with the due care criteria, the case is passed on to the Board of Procurators General and the Health Care Inspectorate.

Committees not competent

The review committees are not competent to review a case if:

• the physician’s actions are considered normal medical practice; the following are in any event considered normal medical practice:
  a. a decision to halt or not start a medically futile treatment;
  b. a decision to halt or not start medical treatment at the patient’s request;
  c. a treatment intended to relieve serious suffering which hastens death;
  d. palliative sedation: deliberately reducing the patient’s consciousness to eliminate  untreatable suffering in the final stage of life (only possible if the patient is expected to live no more than two weeks);

it is clear at the outset that the patient is decisionally incompetent and cannot therefore make a voluntary and well-considered request for euthanasia because the patient is:
a. under the age of twelve (includes neonates); or
b. over the age of twelve but has never been decisionally competent.