Case of Dutch woman held down to be euthanised is going to court

[Quid est Veritas?]

Dutch doctor on trial in euthanasia case

Remember that case where a doctor in the Netherlands forcibly held a dementia woman down in order to kill her? You know, after surreptitiously drugging her coffee failed, since she was so adamantly opposed to being put down?

It has now gone to court, to clarify the law, as the doctor is not being held liable for anything. The patient in question had signed a document saying she wanted to be euthanised instead of being taken to a care home, but once the dementia had set in, she was adamant she didn't want to be. Yet the doctor and some of her family decided to go ahead regardless, in the teeth of her obvious opposition - since, you know, people never change their minds and we are clearly able to tell when consent is no longer able to be given in dementia sufferers or the mentally ill.

We'll see what the Dutch courts decide. In my opinion, regardless of your opinion on euthanasia, you cannot allow someone to be euthanised that is expressly struggling against it - regardless of earlier statements. The possibility of abuse is too rife; or the finality of consent, when often times the real competency or will is hard to determine.

 

[joshua 1 9]

euthanised

Life is always the right choice. Death is never the right choice. The Bible says to choose life. Although the way to eternal life is not always the easy way. "narrow is the gate and difficult is the way which leads to life, and there are few who find it." (Matthew 7:14) We need to die to self so we can live for God.

 

[com7fy8]

Well, while she was well, she might have felt it would be so horrible to live while having dementia. But, once she was actually in the situation, she may have discovered she still could have enjoyments and love people.

So, it might be interesting to ask her why she did not want to die.

How demented had she become? How demented is a person supposed to become, before the person supposedly should be euthanized?? Do you think you should euthanize me when I start to forget what day it is????

It seems there is some sort of indirect euthanasia, when someone stops eating, and they let the person die, instead of using "heroic" efforts to keep the person alive. Of course, starving to death might be not exactly euthanasia which is supposed to be pain free, even comfortable. I am not sure a demented person who stops eating is comfortable while starving to death. And I don't know from experience, to be sure.

Well . . . now I have just read the article. It seems her dementia was "severe". And they had drugged her, but she woke up before they did the needle thing, and then was when she resisted and her family helped to hold her down.

But was she objecting to dying, or objecting to getting the needle stuck in her? I don't think the article makes that obviously clear.

Even so, I don't believe in killing someone. Trust God to decide.

 

[Nithavela]

I don't think people should be euthanised unless they either have their full mental faculties and demand it or are in a coma with no reasonable chance of waking up again.

I am generally in favor of euthanasia, but not in this case.

 

[Ana the Ist]

We'll see what the Dutch courts decide. In my opinion, regardless of your opinion on euthanasia, you cannot allow someone to be euthanised that is expressly struggling against it - regardless of earlier statements. The possibility of abuse is too rife; or the finality of consent, when often times the real competency or will is hard to determine.

I don't know...

Did she request euthanasia because she knew her mind was deteriorating? Dementia is a terrible condition...and I can understand not wanting to put family members through the experience.

 

[Quid est Veritas?]

I don't know...

Did she request euthanasia because she knew her mind was deteriorating? Dementia is a terrible condition...and I can understand not wanting to put family members through the experience.

Here is an old background article:

Doctor reprimanded for 'overstepping mark' during euthanasia on dementia patient - DutchNews.nl

The woman completed a living will four years prior, asking to be euthanised if her dementia became too severe. Thereafter she was admitted to the nursing home and became restless, fearful and at times aggressive. The nursing home doctor decided to carry out the euthanasia, but the patient had refused, saying she did "not yet want to die" on admission. Subsequently they tried to drug her coffee with a sedative; when she woke up and struggled, the doctor asked her family to hold her down, while she euthanised her.

 

[essentialsaltes]

but once the dementia had set in, she was adamant she didn't want to be.

That does not appear to be part of the news story you shared.

in the teeth of her obvious opposition

What it does say is "Prosecutors say the patient showed resistance during the process."

It is not clear (to me) whether the patient 'resisted' because she understood what was happening and wanted it to stop, or because she didn't understand what was happening and was resisting an unfamiliar experience.

 

[essentialsaltes]

Ah, the second article sheds a bit more light:

The case centres on a woman in her 70s, who was diagnosed with dementia four years ago. At the time she completed a living will, saying she did not want to go into a home and that she wished to die when she considered the time was right. After her condition deteriorated, she was placed in a nursing home where she became fearful and angry and took to wandering through the corridors at night. The nursing home doctor reviewed her case and decided that the woman was suffering unbearably, which would justify her wish to die. However, the assessment committee said that the woman’s wish to die when she was admitted to a nursing home did not demonstrate a well-informed wish for euthanasia. In addition, she had told her doctor before being admitted that she did wish to die ‘but not now’.

This is not exactly adamant refusal to be euthanised. I guess it would be useful to understand the timeline and progression of the disease. How long between being admitted to the home and the nursing home doctor making his judgment that she was suffering? How long between that and the move to euthanize? What was her mental condition at that point?

 

[Quid est Veritas?]

Ah, the second article sheds a bit more light:

The case centres on a woman in her 70s, who was diagnosed with dementia four years ago. At the time she completed a living will, saying she did not want to go into a home and that she wished to die when she considered the time was right. After her condition deteriorated, she was placed in a nursing home where she became fearful and angry and took to wandering through the corridors at night. The nursing home doctor reviewed her case and decided that the woman was suffering unbearably, which would justify her wish to die. However, the assessment committee said that the woman’s wish to die when she was admitted to a nursing home did not demonstrate a well-informed wish for euthanasia. In addition, she had told her doctor before being admitted that she did wish to die ‘but not now’.

This is not exactly adamant refusal to be euthanised. I guess it would be useful to understand the timeline and progression of the disease. How long between being admitted to the home and the nursing home doctor making his judgment that she was suffering? How long between that and the move to euthanize? What was her mental condition at that point?

Saying she did 'not want to die now' and having to be physically restrained (and it deemed necessary to attempt it clandestinely) is not adamant refusal of Euthanasia? Weird.

I reported she had previously assented to euthanasia at a later date, so obviously she was not opposed in principle. In practice though, at no point did this woman ever say she was ready to die - yet was put to death.

Further, the fact that it was deemed necessary to try and sedate her without her knowing, and her refusal to get a drip inserted when she woke up, speaks volumes if she had been still somewhat clearheaded. Clearly trying to drug someone without their knowledge, points to doing something against that person's will. It rests on how clearheaded she was, and if not compos mentis, whether she would've agreed. It is quite difficult to determine the level of function in dementia sufferers, especially as it fluctuates. Even if one is put to death that refused, or would have refused, that is too many - death is final, a negating of treatment really, not a treatment modality. The review board found her actions improper though, as well.

 

[Quid est Veritas?]

@essentialsaltes

I looked up the timeline. She was deemed to be still sufficiently sound of mind about 7 weeks prior to her euthanasia, when she still stated she did not yet wish to die. The doctor in question only saw her for these 7 weeks, during which time she said she was not ready to die yet multiple times. The doctor deemed though that she no longer understood what dementia meant, nor properly understood euthanasia toward the end thereof. In light thereof she decided to euthanise her, on grounds of her declaration to that effect 4 years prior and previous willingness at an unspecified future date.

Caveat, the report of the review board is in Dutch, which I can understand to a fair extent being a native Afrikaans speaker, but not perfectly:

https://www.recht.nl/exit.html?id=2...eidseisen/oordeel-2016-85/Oordeel+2016-85.pdf

 

[Nithavela]

Ah, the second article sheds a bit more light:

The case centres on a woman in her 70s, who was diagnosed with dementia four years ago. At the time she completed a living will, saying she did not want to go into a home and that she wished to die when she considered the time was right. After her condition deteriorated, she was placed in a nursing home where she became fearful and angry and took to wandering through the corridors at night. The nursing home doctor reviewed her case and decided that the woman was suffering unbearably, which would justify her wish to die. However, the assessment committee said that the woman’s wish to die when she was admitted to a nursing home did not demonstrate a well-informed wish for euthanasia. In addition, she had told her doctor before being admitted that she did wish to die ‘but not now’.

This is not exactly adamant refusal to be euthanised. I guess it would be useful to understand the timeline and progression of the disease. How long between being admitted to the home and the nursing home doctor making his judgment that she was suffering? How long between that and the move to euthanize? What was her mental condition at that point?

I don't think "did she refuse strongly enough" is the proper test that should be applied before killing someone.

 

[cow451]

I don't think "did she refuse strongly enough" is the proper test that should be applied before killing someone.

Did she have the “capacity” to change her mind? I’m opposed to euthanasia partly because of cases like this one. This is very different than removing life support from a patient that is likely brain dead.

 

[Nithavela]

Did she have the “capacity” to change her mind? I’m opposed to euthanasia partly because of cases like this one. This is very different than removing life support from a patient that is likely brain dead.

If you don't have the capacity to change your mind, you don't have the capacity to agree to be euthanised, and thus you shouldn't be euthanised.

At least, that's my stance on it.

 

[essentialsaltes]

If you don't have the capacity to change your mind, you don't have the capacity to agree to be euthanised, and thus you shouldn't be euthanised.

I can imagine writing out a living will spelling out the circumstances in which I would like to be euthanized. Most of those circumstances would necessarily be ones where I could no longer give meaningful assent, because otherwise there is no point in a living will. I would want my wishes to be obeyed, just as I would the disposition of my property, regardless of my (in)ability to change my mind about leaving everything to Mittens.

 

[Nithavela]

I can imagine writing out a living will spelling out the circumstances in which I would like to be euthanized. Most of those circumstances would necessarily be ones where I could no longer give meaningful assent, because otherwise there is no point in a living will. I would want my wishes to be obeyed, just as I would the disposition of my property, regardless of my (in)ability to change my mind about leaving everything to Mittens.

That would be a different case, but those circumstances would have to be very precise and waterproof, propably double-checked by a qualified doctor and lawyer, so that there is no discussion about it.

 

[essentialsaltes]

That would be a different case, but those circumstances would have to be very precise and waterproof, propably double-checked by a qualified doctor and lawyer, so that there is no discussion about it.

After being diagnosed with Alzheimer's four years before she died, the patient wrote a statement saying that she wanted to be euthanised before entering a care home, prosecutors said.

I don't know if it amounts to a living will, but she made her preferences known.

 

[Nithavela]

After being diagnosed with Alzheimer's four years before she died, the patient wrote a statement saying that she wanted to be euthanised before entering a care home, prosecutors said.

I don't know if it amounts to a living will, but she made her preferences known.

That's not precise enough.

 

[Ana the Ist]

@essentialsaltes

I looked up the timeline. She was deemed to be still sufficiently sound of mind about 7 weeks prior to her euthanasia, when she still stated she did not yet wish to die. The doctor in question only saw her for these 7 weeks, during which time she said she was not ready to die yet multiple times. The doctor deemed though that she no longer understood what dementia meant, nor properly understood euthanasia toward the end thereof. In light thereof she decided to euthanise her, on grounds of her declaration to that effect 4 years prior and previous willingness at an unspecified future date.

Caveat, the report of the review board is in Dutch, which I can understand to a fair extent being a native Afrikaans speaker, but not perfectly:

https://www.recht.nl/exit.html?id=219967&url=https://www.euthanasiecommissie.nl/binaries/euthanasiecommissie/documenten/publicaties/oordelen/2016/niet-gehandeld-overeenkomstig-de-zorgvuldigheidseisen/oordeel-2016-85/Oordeel+2016-85.pdf

I guess the question is if someone can ask to be euthanized under certain conditions at a later time. I'd say yes...and it shouldn't matter how they feel about it once those conditions have been met.

 

[Nithavela]

I guess the question is if someone can ask to be euthanized under certain conditions at a later time. I'd say yes...and it shouldn't matter how they feel about it once those conditions have been met.

I'd say that those conditions would neccessarily have to include heavy mental impairment. Maybe not total catatonia.

There are actually scales for mental impairment in various conditions. I'd say that at least 2 independent doctors would need to reach a certain score treshold, to be named by the person in question.

 

[Ana the Ist]

I'd say that those conditions would neccessarily have to include heavy mental impairment. Maybe not total catatonia.

There are actually scales for mental impairment in various conditions. I'd say that at least 2 independent doctors would need to reach a certain score treshold, to be named by the person in question.

I'd agree that impairment should be standardized and verified by professionals.