A Dutch euthanasia regulator has quit her post in protest at the killings of patients suffering from dementia.
Berna van Baarsen, a medical ethicist, said she could not support “a major shift” in the interpretation of her country’s euthanasia law to endorse lethal injections for increasing numbers of dementia patients.
She has now resigned from one of Holland’s five regional assessment committees set up to oversee the provision of euthanasia.
Miss van Baarsen becomes at least the second regulator to quit in just three years and follows Professor Theo Boer who stepped down in 2014 after he warned British parliamentarians not to follow the Dutch example and to vote against Lord Falconer’s Assisted Dying Bill.
Euthanasia is permissible for mentally incapacitated adult patients under Article 2.2 of the 15-year-old law as long as a patient has left a “written declaration requesting that his life be terminated” in advance.
But Miss van Baarsen, in an interview with Medisch Contact magazine, suggested that lethal injections were increasingly given to patients with fluctuating capacity, leading to a fourfold surge in euthanasia deaths of mental health patients in five years.
“I have seen a major shift in the interpretation of this article in recent years. I cannot support that,” she said.
“I do not believe a written declaration of intent can replace an oral request for incapacitated patients with advanced dementia,” she added. “I find that too short.”
In an interview with Trouw newspaper, Miss van Baarsen said that Article 2.2 applied fairly, for example, to a cancer patient with a wish to die and who slips into a coma.
But she said that dementia was “more erratic and patients often live longer”, with their mental capacity more fluid.
Such patients, she explained, were sometimes able to recognise loved ones in one instance but not on another.
In such situations, she asked: “What is the right moment to grant euthanasia?”
Miss van Baarsen said it was also very difficult to assess if patients with dementia were suffering unbearably, one of the criteria that has to be met before an act of euthanasia is legally permissible.
“If you are not entirely sure, you cannot assume unbearable suffering,” she said. “Euthanasia based on a prior declaration of consent may only be carried out if all other due diligence requirements have been met – and it has therefore been established that the suffering is indeed unbearable.”
The resignation of Miss van Baarsen comes just months after police in Holland launched their first investigation into a death by euthanasia.
This followed the referral to prosecutors of the case of an elderly woman with dementia who was drugged and then pinned down while she was injected with lethal drugs.
The doctor involved has already been formally reprimanded for performing the euthanasia because the patient could not properly consent.
When the woman was first diagnosed with dementia, however, she had indicated that she was willing to end her life by euthanasia “but not now”.
Her nursing home decided that the moment had arrived when her condition deteriorated and she began to wander the wards at night and behave aggressively.
The doctor drugged the woman’s coffee to calm her and also asked the woman’s family to hold her down when she “reacted negatively” to the procedure and ripped out a drip carrying the euthanasia drugs.