Netherlands Public Prosecutor questions euthanasia rules for people who cannot consent

By Alex Schadenberg, Executive Director, Euthanasia Prevention Coalition.

Last November I published an article reporting that,  based on the Netherlands Supreme Court’s decision in April 2020, the five regional euthanasia review committees in the Netherlands had agreed to rules to expand euthanasia to include people with dementia.

On July 20, 2021, The Dutchnews.nl published an article based on a report in the Trouw News stating that the public prosecutor was questioning the new euthanasia rules for people with dementia who cannot consent. 

The Dutchnews.nl article reports that the dispute “centres on who has the last word about euthanasia –the courts or the [regional euthanasia review] committees– and about how far doctors can go to help someone to die who is no longer able to ask for it.”

The article reports that the new guidelines state that:

“In giving euthanasia to a patient who is no longer mentally competent as a result of advanced dementia, it is not necessary for the doctor to agree with the patient the time or manner in which euthanasia will be given… (since) this kind of discussion is pointless because such a patient will not understand the subject.”

The public prosecution department chief Rinus Otte says this goes too far. Otte told Trouw News that this is not in line with the law and doctors can still face prosecution for murder.

Trouw News reported, according to the article in The Dutchnews.nl , that the regional euthanasia review committees are in talks to revise the code and a new version of the code will be published by the end of the year.

This is an important issue since Canada’s federal government and the Québec regional government have both established committees to discuss the further expansion of euthanasia in Canada. 

One area under discussion is permitting euthanasia for people who are incompetent (dementia) but have previously requested it in their advanced directive prior to becoming incompetent.

However, if it is lawful to kill someone with dementia who cannot request it, but indicated at some point in the past support for this type of death, then soon it will become described as “cruel” not to lethally inject someone with dementia who never asked for it. As I have stated before, euthanasia for people with dementia justifies non-voluntary euthanasia.

The dispute between the public prosecutor and the regional review committees will likely cause Netherlands physicians to refuse to do euthanasia for incompetent people with dementia in order to avoid a possible prosecution.

Once euthanasia is legal, there is no limit for its use. It will be—and already is—argued that limiting euthanasia to competent people who make a clear request is discrimination for incompetent people who can no longer make that  request.