Dutch doctors allowed to sedate dementia patients before euthanasia injections

By Senay Boztas
Sat, November 21, 2020, 2:12 AM GMT+7
Dutch doctors allowed to sedate dementia patients before euthanasia injections


The Dutch Supreme Court has updated the country's right-to-die medical code - Mike Corder /APNew euthanasia rules in Holland will allow doctors to spike patients' drinks with sleeping pills to stop them becoming violent before lethal injections.

The changes to the country's right-to-die medical code come in the wake of a court ruling that overturned a murder charge against Marinou Arends, a nursing home doctor.

Dr Arends had secretly slipped sedative into the coffee of a 74-year-old female dementia suffer before administering a lethal injection. The woman had reached an advanced stage of dementia, where she was no longer capable of giving any kind of informed consent on the timing of the treatment.

Critics also said the patient was robbed of the dignified end that euthanasia is supposed to provide. When she had sat up in bed in a bid to avoid being given the injection, a relative had pushed her back down.

Dr Arends later said that the woman had been asked on three occasions if she wanted euthanasia, and had refused each time. However, the doctor then judged her mentally incompetent, relying instead on her earlier euthanasia directives and the agreement of the woman's husband, who had power of attorney.

Dr Arends was given a written reprimand by the Dutch medical board over the way the patient was manhandled, and for administering the sedative without the patient's consent. She said the drug was given in an attempt to avoid the woman feeling ‘panic’, adding that it was an accepted practice if done with the the consent of those wielding power of attorney.

The Dutch Supreme Court has now said the doctor had acted within Holland's 2002 euthanasia law, ruling that if a patient was no longer capable of consent due to dementia, medics had the leeway to decide for themselves when the time was right to terminate their life.

The court's verdict has alarmed opponents of euthanasia, who claim that Holland - a pioneer in the practice - is interpreting the rules ever more widely.

However, the country's euthanasia review committee believes that the amendments to its code will give doctors extra legal backing in cases where it is "pointless" to try seeking consent.

The new code says that in cases where a patient has advanced dementia, “it is not necessary for the doctor to agree with the patient the time or manner in which euthanasia will be given”.

It also backs doctors putting sedatives in advanced dementia sufferers' food or drink if they are concerned that they will become “disturbed, agitated or aggressive”.

Jacob Kohnstamm, chairman of the RTE, said the clarification stressed doctors’ reasonable, professional judgement and could relieve fears of prosecution.

"It’s only two or three cases a year but this might help doctors to have less fear of a penal case,” he told The Telegraph.
The ruling has been opposed by some Dutch medical practitioners. When news of Dr Arends’ case first emerged in 2018, more than 200 medics issued a statement saying that no doctor should be allowed to secretly sedate patients before euthanasia.

Dr Jaap Schuurmans, who has researched cases of patients' relatives pressuring doctors to fast-track euthanasia, said: “This freedom has been there in law from the beginning, but the law is being interpreted more and more broadly. Nobody can look inside the head of someone with dementia."

The Netherlands, which is known for its socially liberal attitudes, was among the first countries to legalise euthanasia and assisted suicide.
Last month, the Dutch government also approved plans to allow euthanasia for terminally ill children, arguing that it would stop them ""suffering hopelessly and unbearably".