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Dutch court clears doctor in landmark euthanasia trial Dutch doctor acquitted in landmark euthanasia case
(about 2 hours later)
A Dutch doctor has been acquitted in a landmark trial that prosecutors and health professionals hope will help clarify how the country’s 2002 euthanasia law can be applied to people with severe dementia. A doctor who slipped a sedative in her patient’s coffee before administering a lethal drug to her has been acquitted of breaking Dutch euthanasia laws in a landmark case.
The doctor was cleared of any wrongdoing in carrying out euthanasia three years ago on a 74-year-old woman, who was given fatal doses of drugs despite some indications she might have changed her mind since declaring in writing that she wanted euthanasia. Prosecutors had accused the unnamed doctor of failing to consult the 74-year-old, who had Alzheimer’s, but a judge ruled that a declaration written by the patient four years earlier had sufficed.
Judges at the Hague district court ruled that the doctor met all criteria for carrying out euthanasia under the Dutch law legalising mercy killing by physicians. Applause broke out in the courtroom after the court heard that the doctor had been right to abide by the woman’s stated wishes and that there was no legal duty to verify the “current death wish” in such a case.
The doctor was accused of not acting with due care because, prosecutors alleged, she made insufficient efforts to find out whether the patient still wanted to die. To carry out the euthanasia, the physician drugged the patient’s coffee without her knowledge and then had family members physically restrain the woman while delivering the fatal injection. “We conclude that all requirements of the euthanasia legislation had been met. Therefore the suspect is acquitted of all charges,” the judge, Mariette Renckens, told the court in The Hague. “We believe that given the deeply demented condition of the patient the doctor did not need to verify her wish for euthanasia.”
Prosecution spokeswoman Sanne van der Harg said prosecutors would carefully study the judgment before deciding whether to appeal. The court’s verdict was seen as an important test of the Netherlands’ pioneering euthanasia laws, given that people are living longer and are more likely to develop conditions that leave them confused in their final years.
Under Dutch law, people are eligible for euthanasia if they make a considered, voluntary request for it and if their suffering is hopelessly “unbearable”. Patients can draw up a written request for euthanasia to be performed sometime in the future, in an advance directive, which should specify the conditions determining when they want to be euthanised. Doctors must also seek the advice of at least one other independent physician before killing the patient. Since 2002, doctors in the Netherlands can carry out euthanasia if a patient is enduring “unbearable and endless suffering” and has requested to die “earnestly and with full conviction”.
Euthanasia cases among people with advanced dementia are extremely rare; there have been fewer than 20 cases since the procedure was legalised in 2002. The case, the first that has gone to trial, centred on whether the deceased woman had consented.
“The most important issue we have to judge as doctors is whether there’s unbearable suffering for the patient,” said Dr Rene Heman, president of the Royal Dutch Medical Association. The patient had said in her written statement that she wanted to be euthanised rather than being put into a care home. But she had added that she wanted “to be able to decide [when to die] while still in my senses and when I think the time is right”.
He said the organisation is currently working on guidelines for how doctors should handle euthanasia cases in people with advanced dementia. Before the patient was taken into care, the doctor decided that it was appropriate to euthanise her, a decision confirmed by two separate doctors, and a date for her death was set.
“As a doctor, you need to make sure people don’t change their minds,” he said. On the day, the doctor had a mid-morning coffee with the patient, her husband and her adult daughter, in what was described by the medic as a “cosy” atmosphere.
Dutch investigators began scrutinising the case last December, marking the first time a doctor was criminally investigated for euthanasia. During this period, the doctor put a sedative into the patient’s drink.
The 74-year-old woman had renewed her living will about a year before she died, writing that she wanted to be euthanised “whenever I think the time is right”. Later, the patient said several times in response to being asked if she wanted to die: “But not just now, it’s not so bad yet!” according to a report from the Dutch regional euthanasia review committee. After half an hour, the woman felt sleepy but she did not go to sleep. A second dose of the sedative was administered via injection. The patient, although woozy, indicated her displeasure at the pain of the needle.
While she was asleep, the doctor attempted to administer a lethal dose of a different drug but the woman stirred from her sleep and stood up and had to be held down by her family to allow the final injection to be given.
The woman’s daughter supported the doctor’s decisions in a statement to the court in which she said that her actions “freed my mother from the mental prison which she ended up in”.
Prosecutors had asked judges not to sentence the doctor even if she was found guilty as she had “acted with the best intentions”.
Robert-Jan van Eenennaam, the lawyer representing the 68-year-old doctor, who was not in court, said his client would be delighted with the verdict.
He said: “The judges were very clear in their verdict that she acted in the correct manner. But my client still feels that a criminal case was not the correct way to deal with the issue. She has been through a lot these past few months.”
A spokeswoman for the prosecution, Sanne van der Harg, said: “We will now carefully study the verdict and decide at a later stage whether we will lodge an appeal.”
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Assisted dying
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