Euthanasia consent by gestures

A decision by authorities in the Netherlands has once again lowered the bar for euthanasia in that country. In this case it was determined that hand squeezes, nods, eye blinking and crying (!) were all sufficient signs of consent from a woman drifting in and out of a comatose state to go ahead with euthanasia.

Victoria's assisted suicide bill, which is scheduled to come into effect on 19 June 2019, explicitly provides for assisted suicide and euthanasia requests to be made by gestures.

The Board of Procurators General of the Netherlands announced on 26 October 2018 that it has decided not to prosecute a doctor who performed euthanasia on a 72-year-old woman in April 2017 and to dismiss the case unconditionally. An East Netherlands prosecutor at the request of the College carried out a criminal investigation into possible punishable euthanasia by the physician. On the basis of the results of the criminal investigation, the doctor can not be charged with a criminal offense. The doctor has acted in accordance with the care standards.

Since 2016 the Board has finalised 18 other cases referred to it by the Euthanasia Review Committees including 8 cases of botched execution of assisted suicide or euthanasia where the wrong drugs were used, where the person was not fully sedated before being given possibly painful lethal drugs, or where no back up euthanasia drugs where brought and the person had to wait for some time after a failed attempt at assisted suicide. Five of these cases were dismissed unconditionally. In 3 cases the doctor was placed on one year probation. 

The problems revealed in these cases by failed attempts at assisted suicide are instructive. In the Netherlands the law requires a doctor to be present when the assisted suicide drugs are taken and to remain until the person dies. The doctor is supposed to bring a back up euthanasia kit as it is understood that assisted suicides are sometimes unsuccessful. In places like Oregon - and from June 2019 in Victoria - there is no requirement for a doctor to be present at an assisted suicide attempt.

Another 3 cases where the doctor failed to bring a back up second euthanasia kit and the person had to wait after a failed first attempt at euthanasia were all dismissed unconditionally.

Four further cases involved questions about the independence of the consultant - all dismissed unconditionally.

Three cases centred on whether or not the person met the eligibility criteria. One was dismissed unconditionally. In the other two cases the doctor was given one year's probation. In one of these cases a doctor from the End of Life Clinic went ahead with euthanasia despite the views of the patient’s neurologist and psychiatrist that further treatment options were available for his mild Parkinson’s disease, treatable anxiety and mood disorder.

The take home message is that even where the law on euthanasia is clearly breached the most sloppy, negligent or arrogant doctors face for unlawfully killing a person seems to be one year probation - that is essentially a good behaviour bond. 

There are currently four other cases being investigated by the Board. Decisions are expected in the next few weeks.

One of these cases involves a woman with dementia who resisted being given a needle but was restrained and then killed by lethal injection.