Monday, 20 January 2014

The euthanasia law in The Netherlands is derailed

This is an edited version of a report written by Tom Mortier.

Tom Mortier

In January 2014 the euthanasia debate unexpectedly re-ignited. According to the Dutch Newspaper Trouw there is a growing argument amongst doctors concerning euthanasia performed on a 35-year-old psychiatric patient in 2012 ( see: http://nieuwsuur.nl/video/598441-euthanasiewet-is-ontspoord.html ).

A young woman with psychiatric problems asked her general practitioner to help her to die. To process the request, her general practitioner consulted an independent doctor, but this doctor gave a negative recommendation. A second independent doctor ruled that the euthanasia request could not be granted because, according to him, there were still treatment options available to the patient.

The general practitioner decided to approach a third doctor, a psychiatrist, who only needed two weeks to conclude that the problems of the 35-year old woman were untreatable and thus a lethal injection was legitimized.

Two days later, on December 19 2012, the patient was killed. In April 2013 the regional Review Commission on Euthanasia reviewed the case and found that the euthanasia was performed ‘carefully’. This finding sparked a heated discussion between the doctors. One of them, George Wolfs, has submitted a complaint against the Commission because he believed that he had received a negative 'treatment' during the hearings in front of the Review Commission on Euthanasia. Under the now twelve year old Dutch Euthanasia Act there had never been such a complaint.

But now, also the Dutch psychiatrist Boudewijn Chabot, one of the country’s most famous euthanasia advocates, has written an opinion in the Dutch newspaper NRC Handelsblad saying that the euthanasia law in The Netherlands is ‘derailed’. He came to this conclusion after looking at some remarkable Dutch euthanasia cases.

Fourteen cases for euthanasia or assisted suicide delivered to psychiatric patients were reported at the Dutch regional euthanasia review committees in 2012. There were 13 similar cases in 2011. The euthanasia review committees judged that all the cases in 2012 were performed ‘carefully’. In 2013, the euthanasia review committees came to the conclusion that seven from the nine euthanasia cases from psychiatric patients performed by the Levenseindekliniek (Life end clinic) were ‘carefully done’.

The Life End Clinic consists of thirty travelling teams having a doctor and a nurse performing euthanasia anywhere in The Netherlands.  Most of the doctors working for this clinic are general practitioners and internists, but there are also two psychiatrists. One of the psychiatrists is Gerty Casteelen.
House calls in Holland

Casteelen helped a 54 year old woman suffering personality disorder, eating disorder and a chronic obsessive-compulsive neurosis to die by euthanasia. Casteelen says that she doesn’t find it hard to kill her patients because she believes she is doing something good, stating that she makes people very happy. Not only the patient, but also the family who sees their loved one was suffering on a daily basis.

A physically healthy man of 63 also died by euthanasia in 2013. He was working for a government institution. He never had a relationship and the only thing he did his whole life was working. He had been treated for some time for depression, but the treatment didn’t work out. He also tried to commit suicide, but failed. According to psychiatrist Casteelen this man found believed that he didn’t had a right to live. The night before his death, this man gave a farewell reception for his colleagues. The day after, Casteelen went to his house and helped him to die.

The fact that psychiatrist Boudewijn Chabot has slammed the Dutch Euthanasia law; saying that it has become ‘derailed’ is remarkable.  In 1994 he was found guilty of helping a woman with mental problems with assisted suicide. The judge didn’t punish him or impose any sanction upon him because of the ‘exceptional circumstances’ of this case and because he was ‘acting carefully’. In fact, it was the judge’s decision in this case that became the basis of the Dutch euthanasia law.

More than 4000 people a year now die by euthanasia in The Netherlands. Those who, for whatever reason, don’t receive help from the own general practitioner or psychiatrist can now go to the Life End Clinic. Chabot believes that psychiatric patients should only be helped by their own treating practitioners. Furthermore, he states that ‘he does not feel comfortable’ because the Dutch euthanasia law has flaws and he is startled by the recent developments in the country.



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