Dutch cardinal fears surge in euthanasia

MANCHESTER, England -- A Dutch cardinal predicted that the number of euthanasia cases will surge after the Netherlands’ highest court gave the green light to allow the killing of dementia patients who are no longer able to give consent.

The court ruled April 22 that doctors could euthanize patients with severe dementia and who could no longer express their wishes if they had left an advance request in writing to say they wished to die.

Cardinal Willem Eijk of Utrecht, president of the Bishops’ Conference of the Netherlands, said, however, the court’s ruling would not only make it easier for doctors to take the lives of dementia patients but would also put them under pressure to do so. He said the ruling created greater uncertainty rather than clarity over the practice of euthanasia.

“Patients and their relatives could think on the basis of the judgment ... that there is a kind of a right to euthanasia in cases of advanced dementia with suffering, deemed without prospect (of recovery) and unbearable, though the Supreme Court does not say that and the law on euthanasia does not oblige a physician to perform euthanasia,” Eijk said in a statement.

“Physicians of nursing homes therefore fear that they will be put under pressure by patients with dementia and their relatives to perform euthanasia as a consequence of the Supreme Court’s judgment,” he said.

The court ruling was in response to the acquittal of a doctor who in 2016 drugged a woman with Alzheimer’s disease, who had been resisting his attempts to give her a lethal injection, so he could finally euthanize her.

The 74-year-old patient had earlier instructed her family that she wanted to die by euthanasia, but at a time of her choosing. She became so demented that she was unable to say when she wished to die so her family interceded. Because she fought against the injection, the doctor slipped sedatives into her coffee and her family held her down.

Prosecutors accused the doctor of ignoring a requirement of consent written into the Dutch euthanasia law of 2002, arguing the patient might have changed her mind about wishes she had expressed in writing four years before her death. A lower court ruled the doctor had not behaved illegally and in 2018 acquitted him, and the case was referred to the Supreme Court for legal clarification “in the interest of the law.”

The Supreme Court concluded that “a physician may carry out a prior written request for euthanasia in people with advanced dementia,” providing other criteria on “unbearable and endless suffering” also were met.

In his statement, Eijk noted that in 2017, during the prosecution of the doctor, the euthanasia rate fell by seven per cent, but in 2019, following his acquittal, it rose by nearly four per cent.

The cardinal also questioned whether an advance declaration could accurately express the actual will of a patient.

“In her declaration, the woman said that she wanted euthanasia, when she would have been admitted to a nursing home one day, but something in this declaration remained unclear: she determined that the euthanasia should take place at a moment that she thought she would be ready for it,” he said.

“But after having been admitted to a nursing home, she was not able to indicate whether she desired euthanasia or not,” he said.