Introduction

Webcast archive: Dutch doctor “acted in good faith”

Today, we're discussing the reaction of Dutch authorities to a doctor who drugged a woman resisting euthanasia.

Webcast archive: Dutch doctor “acted in good faith”

In this episode of Euthanasia & Disability, Amy Hasbrouck and Christian Debray discuss:

  • Dutch doctor “acted in good faith” in death of woman with dementia
  • Québec bioethicists call for organ donations after euthanasia

Please note that this text is only a script and that our webcast contains additional commentary.

DUTCH DOCTOR “ACTED IN GOOD FAITH” IN DEATH OF WOMAN WITH DEMENTIA

  • A Dutch regional review committee which oversees Holland’s euthanasia program found that a doctor who drugged and then restrained a person in order to euthanize her deserved a reprimand, but did not break the law.
  • The person was a woman in her 80s with dementia.  She had stated in her will that she didn’t want to end up in a nursing home and wanted assisted suicide “when I myself find it the right time.” When her husband could no longer care for her at home, she was moved to a nursing home, where staff reported she was often frightened and angry, and wandered the halls at night.  After a few weeks, the doctor at the nursing home determined that the woman was “suffering unbearably” and therefore qualified for euthanasia.
  • Despite reports that she stated she did not want to be euthanized in the days leading up to her death, the doctor did not discuss euthanasia with the woman, so as not to upset her.  Instead the doctor put a sedative in her coffee, and began to administer the euthanasia injection after the woman fell asleep.  The woman awoke and tried to sit up, at which point the doctor asked her family to restrain her so she could complete the injection.
  • The review committee determined that the woman’s declaration in her will did not clearly state that she wanted to be euthanized after being admitted to a nursing home.
  • The committee also concluded that the doctor “crossed a line” by giving the woman the first dose of sedative secretly, and should have stopped once the woman moved, even if it was a reflex.
  • Despite these “irregularities”, the committee found the doctor acted in good faith in finding that the woman qualified for euthanasia because of unbearable suffering.
  • The review committee added that the case should come to court so that judges can confirm that any other doctor who acts in good faith when providing euthanasia to people with dementia cannot be prosecuted.
  • The lack of consequences for “irregularities” is not limited to the Netherlands.  The Québec Commission on end-of-life care found 21 cases (of 148 analyzed) with irregularities, including three where euthanasia was performed on people who were not eligible.  Yet none of the doctors who violated the law were sanctioned.  Which raises the question: what use are safeguards if they are not enforced?

QUÉBEC BIOETHICISTS CALL FOR ORGAN DONATIONS AFTER EUTHANASIA.

  • In an article published in December by the Journal of Medical Ethics, two bioethicists from the Université de Montréal call for organ donation after euthanasia.
  • The authors state that: “ (medical aid in dying) has the potential to provide additional organs available for transplantation. Accepting to procure organ donation after MAID is a way to respect the autonomy of patients, for whom organ donation is an important value. Organ donation after MAID would be ethically acceptable if the patient who has offered to donate is competent and not under any external pressure to choose MAID or organ donation.”
  • The authors, Julie Allard and Marie-Chantal Fortin, say that the decision to donate organs should be kept separate from the decision to be euthanized, but they admit that “It will be difficult to disentangle patients’ motivations for requesting MAID.”  They believe that “the complete separation of the two decisional processes should help to ensure that the MAID request is motivated by unbearable suffering, as required by law, and not by the feeling that one’s value is limited to one’s organs.”
  • The researchers do not explain how separation of the euthanasia and organ donation requests will reduce the person’s sense of being a burden, and the feeling that they can only “be useful” by donating their organs.
  • In addition, Québec’s Commission on Ethics in Science and Technology has endorsed the plan.  “Considering that a request for medical help in dying is a right, that organ donation is socially acceptable and it is an express request of the patient, and considering that the Commission has always supported organ donation in preceding position statements, the Commission recommends that all the institutions responsible set in place the necessary conditions for making these two requirements compatible.”
  • This proposal, like the cost-savings research we discussed last week, both emphasize the “benefit” of euthanasia, to society and increase the pressure on people to give up their lives for the “greater good”.  During this week of suicide prevention in Québec, this is the wrong message to be sending.