Euthanasia advocate says: "The door has been opened wide for euthanasia of patients with severe dementia."
Boudewijn Chabot, a Dutch euthanasia advocate, has written a lengthy opinion piece denouncing the eroding of safeguards for vulnerable patients.
Chabot was prosecuted for the 1991 assisted suicide of a 50-year-old healthy woman suffering from "existential distress." Though he was found guilty of the crime, he wasn't punished. The case became a landmark, however, leading to the Euthanasia Act of 2002, which legalised, by statute, assisted suicide and euthanasia in the Netherlands. Chabot is completely in favour of "self-determination" when it comes to euthanasia, writing chillingly that the continuing increase of cases "does not disturb me - even if the number exceeds tens of thousands in a few years."
Execution of dementia patients
However, he says, "what does worry me is the increase in the number of times euthanasia was performed on dementia patients, from 12 in 2009 to 141 in 2016, and on chronic psychiatric patients, from 0 to 60."
He recounts some of the horrific cases of patients of advanced dementia being euthanized without consent, such as one woman whose coffee was drugged, and who when she tried to struggle was held down by her family, and another where a husband mixed sleep medication in the porridge of his demented wife before the GP arrived with his deadly syringe. He describes both of these cases as "executions".
What is happening?
"To understand what has gone wrong, the reader must know the three most important 'due care criteria' of the law. There must be: 1) a voluntary and deliberate request; 2. unbearable suffering without prospect of improvement; 3. No reasonable alternative to euthanasia," he says.
Chabot explains that the conditions for euthanasia are being eroded. For example, "once upon a time, moving to a nursing home or receiving treatment with some medication was still considered a 'reasonable alternative' for euthanasia." However, ethicist Govert Hartogh, a member of the euthanasia Evaluation Committee, now says: "The patient suffers unbearably when he says he suffers unbearably and an alternative is not a reasonable alternative if the patient rejects it. In fact, these requirements then add little to the requirement of a voluntary and thoughtful request."
Chabot is also worried about the recent development that prior written consent for euthanasia is now taken to have the same weight as verbal consent. The patients' own determinations of "unbearable suffering" as well as his written consent now being sufficient, "the door has been opened wide for euthanasia of patients with severe dementia."
Slippery slope
Interestingly, Chabot compares the erosion of safeguards to what happened with abortion law. "In order to get abortion, a woman had to be in an 'emergency' situation. Soon every woman knew that she got what she wanted if she requested it and rejected any other solution." He also says that most patients are killed not in hospitals but by The End of Life Clinic, which "offers access to euthanasia to patients whose own physicians have denied their request for euthanasia" and whose physicians have "very little expertise in palliative care". Church Militant points out that "like abortion mills, the doctors there do not provide care for the patient but only purport to alleviate suffering by killing him".
Incapacitated people being surreptitiously killed
Chabot's conclusion serves as a warning of the danger vulnerable people in this country would be put in if euthanasia was ever made legal.
"The euthanasia practice is running amok because the legal requirements which doctors can reasonably apply in the context of physically ill people, are being declared equally applicable without limitation in the context of vulnerable patients with incurable brain diseases. In psychiatry, an essential limitation disappeared when the existence of a treatment relationship was no longer required. In the case of dementia, such a restriction disappeared by making the written advance request equivalent to an actual oral request. And lastly, it really went off the tracks when the review committee concealed that incapacitated people were surreptitiously killed."
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