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Editorial

Abbot Peter Novecosky, OSB

02/22/2017

Abbot Peter NovecoskyEuthanasia and dementia

Doctors around the world are facing new challenges with euthanasia. Canada now has a law that allows for doctor-assisted suicide or euthanasia. Other countries have a longer history in dealing with it, and with cases going badly.

Alex Schadenberg, executive director of Euthanasia Prevention Coalition, is an active opponent of the drive to allow euthanasia, or to widen the criteria for allowing it. He keeps regular tabs on legislation being introduced around the world.

Recently he reported on a case in the Netherlands which seems very problematic. And its outcome was even more astonishing. Cases in the Netherlands continue to serve as a caution of what could occur in Canada.

The Netherlands case involves a doctor secretly putting a drug in the coffee of a woman with dementia to calm her. Then she started to give her a lethal injection. 

While injecting the patient, she woke up and fought the doctor. The paperwork showed that family members had to help restrain her so her doctor could complete the injection. 

In the days before her doctor-assisted death the patient had said several times, “I don’t want to die.” Reports indicate the doctor had not spoken to her about what was planned because she did not want to cause unnecessary extra distress. She also did not tell her about what was in her coffee as it was also likely to cause further disruption to the euthanasia process. 

The Netherlands Regional Euthanasia Review Committee concluded that the doctor had “crossed the line” by putting sleeping medicine into her coffee. It also judged she should have stopped when the woman resisted.

The 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 words “when I myself find it the right time” does not take into account a situation in which the woman was no longer mentally competent. Committee members said they understand how the doctor read it as a wish, but they still felt it was too broad an interpretation. 

The committee chair wants to bring the case to court to create a precedent. Surprisingly, he wants the court decision to protect doctors, not patients. The verdict would enable other doctors to lethally inject people with dementia, without consent, and without fear of legal repercussions. 

The committee says that if doctors act “in good faith” they should be able to do what they have to do when it comes to the euthanasia of patients suffering from severe dementia.

However, the Feb. 10 Dutch NL Times reports that doctors are resisting this latest trend which has allowed three patients with advanced dementia to be euthanasized since the rules were adjusted in December 2015. 

A group of 220 Dutch doctors have taken out an advertisement to show they are against granting euthanasia to advanced dementia patients. The doctors believe it’s wrong to give euthanasia based on a statement which the patient can no longer confirm. 

“Our moral reluctance to end the life of a defenceless human being is too big,” the ad reads. Among the signers are doctors specialized in helping patients die, the article stated.

In Canada, the vice-president for medical professionalism with the Canadian Medical Association reports that Canadian doctors are struggling with participating in “assisted dying” procedures. Jeff Blackmer said doctors have been telling his group that they struggle with taking part in assisted-death procedures. 

As reported in Schadenberg’s blog, Blackmer said physicians who have agreed to help a patient they knew well may find it difficult to help subsequent patients. 

“They will say, it was just too difficult and too traumatizing physiologically and it is not something I will go through again,” he said. “They really struggle with it, and for some of those that is the only one they will do.”

Blackmer said some of Canada’s physicians are entirely ruling out providing end-of-life assistance to future patients.

This scenario is no surprise to those who are pushing protection of conscience rights for medical professionals. They should not be forced to carry out procedures that violate their consciences. And who knows what new procedures will be required in the future.