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Approval of euthanasia for patient with Alzheimer’s disease

The Netherlands first officially reported case of a doctor complying with a request for assisted suicide from a patient with Alzheimer’s disease was lawful, a report has said.

The case was reported to the Netherlands assessment committee system. Committee members have defended their decision, maintaining that approval for the case did not show that the country was on a “slippery slope” towards a general acceptance of euthanasia for cases of Alzheimer’s disease.

The case emerged in the 2004 annual report of the committees, who judged the four of the 1886 cases of euthanasia and assisted suicide in 2004 failed the legal requirements and, as the law requires, forwarded these to the public prosecution service. But, in contrast, the case of a patient with Alzheimer’s was considered to have met the criteria for a “well-considered and voluntary request” to die. The patient was also considered to be “suffering hopelessly and unbearably”, which is another of the criteria that make euthanasia lawful.

The committees’ report states that, in general, patients with Alzheimer’s disease could not always comply with the requirements but that “in specific circumstances” they could. The 65-year old patient had had Alzheimer’s for three years. Since his diagnosis he had said that he did not wish to endure the full course of his illness and had in the previous year repeatedly asked for help to commit suicide.

The doctor judged him to be suffering unbearably. He was conscious that he could no longer function independently and faced the future prospect of increasing dementia.

However a second opinion, from a doctor trained through the national programme for support and consultation with euthanasia, did not recognise such suffering. This doctor argued that the patient’s awareness of his suffering would decline as the disease progressed and doubted that the patient was competent to express his wished.

Further consultations with a psychologist, a nursing home doctor, and a geronto-psychiatrist, however, all concluded that the patient was suffering unbearably because he was aware that the disease was removing his control over his life. They also believed that he remained competent.

Source: Newsletter RtD-Europe, September 2005.

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