A 64-year old Dutch woman, suffering from a progressive state of Alzheimer’s, received euthanasia. The case was extensively reviewed by all (5) Review Committees and considered to be ‘careful’- in compliance with the law.Although the woman, at the precise moment of the application of euthanasia, was not always completely competent, both the family doctor and the (legally obligatory) second opinion doctor (SCEN) assessed her situation as being in compliance with her wishes. These wishes had been subject of discussion between the family doctor and the patient, even long before the feared diagnosis was made, because she had horrid experiences with the dyingprocess of her mother as Alzheimer’s patient. The woman registered her wishes (“in case of…” “I want….”) in her living will and discussed this regularly with her doctor. The SCEN-doctor found her situation such that compliance with the (written) request and the application of the euthanasia was appropriate. As said, the Review Committee(s) agreed.
(comment RJ: The lesson of this case is NOT that from now on in the Netherlands all cases of progressive Alzheimer can have their (written) euthanasia request complied with. Decisive in this particular case was the longlasting relationship between doctor and patient and the continuous discussions about her wishes when she would be diagnosed as Alzheimer’s. She had stated in her living will in such clear words about what she considered to be “the limit” of her acceptance, that this could be assessed by others at the right moment. The lesson is thus that making a living will in clear and precise words, long before a request couild become actual and keep talking about it with the concerned doctors is of the utmost importance!)