Dutch Woman With Dementia Euthanized Against Her Will. The Doctor Was Just Cleared Of Wrongdoing.

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Re: Dutch Woman With Dementia Euthanized Against Her Will. The Doctor Was Just Cleared Of Wrongdoing.

Postby circular » Wed Apr 22, 2020 10:35 am

It seems the case in the original post has been clarified in the courts:

Dutch court allows euthanasia in advanced dementia cases
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Re: Dutch Woman With Dementia Euthanized Against Her Will. The Doctor Was Just Cleared Of Wrongdoing.

Postby TheBrain » Thu Apr 23, 2020 5:17 am

circular wrote:It seems the case in the original post has been clarified in the courts:

Dutch court allows euthanasia in advanced dementia cases


Thanks, circular.

The original reporting contradicts what’s stated in the latest article (the first page contains the link for this thread):

And in the case of this specific Dutch woman with dementia, she never once gave an express request to be euthanized. In her will, which was renewed about a year before her death, the woman said she would like to be euthanized “whenever I think the time is right.” And when she was asked if she wanted to be euthanized, she reiterated multiple times that her suffering was not bad enough to where she wanted to be killed.
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Re: Dutch Woman With Dementia Euthanized Against Her Will. The Doctor Was Just Cleared Of Wrongdoing.

Postby circular » Thu Apr 23, 2020 10:56 am

TheBrain wrote:Thanks, circular.

The original reporting contradicts what’s stated in the latest article (the first page contains the link for this thread):

And in the case of this specific Dutch woman with dementia, she never once gave an express request to be euthanized. In her will, which was renewed about a year before her death, the woman said she would like to be euthanized “whenever I think the time is right.” And when she was asked if she wanted to be euthanized, she reiterated multiple times that her suffering was not bad enough to where she wanted to be killed.

I found it confusing but still think it's the same case.

The article I posted yesterday says:
Tuesday's ruling follows the criminal and disciplinary case against a nursing home doctor who in 2016 ended the life of a 74-year-old woman suffering from dementia.

The woman had written a directive asking for euthanasia in the event she was admitted to a nursing home with dementia and she thought the time was right. [Emphases added]

The first article posted here from September 2016 says:
Three years ago [2016 - same year], a 74-year-old Dutch woman [same age] with dementia was euthanized by a doctor ...

And in the case of this specific Dutch woman with dementia, she never once gave an express request to be euthanized [at the time of euthanasia]. In her will, which was renewed about a year before her death, the woman said she would like to be euthanized “whenever I think the time is right.” And when she was asked if she wanted to be euthanized, she reiterated multiple times that her suffering was not bad enough to where she wanted to be killed ...

Part of the rationale for clearing the doctor of drugging the patient’s coffee without her knowledge and killing her while she was being physically restrained against her will was in part, according to the court verdict, because “the patient no longer recognized her own reflection in the mirror,” [Emphases added]

This points up just how thorny it can get to pre-plan for dementia euthanasia. It suggests that if you write into an advance directive that you want to have a final say when you actually have dementia, that can be overridden based on medical facts and experiences you may be forgetting you are enduring when the time comes. Dementia patients can feel, look and speak fine in one moment and believe things are not that bad, while also completely forgetting all kinds of agony and discomfort they are enduring at other times of the day or night. I've seen this up close and personal. It's another example of why choosing the right healthcare POA is so crucial and probably also giving them permission to not go by your word at the time if you are forgetting other circumstances the POA feels would be impacting your decision.

I hope my train of thought is clear. I have bad allergy brain fog today and am not tracking well.
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Re: Dutch Woman With Dementia Euthanized Against Her Will. The Doctor Was Just Cleared Of Wrongdoing.

Postby NF52 » Thu Apr 23, 2020 3:46 pm

TheBrain wrote:
circular wrote:...This points up just how thorny it can get to pre-plan for dementia euthanasia...It's another example of why choosing the right healthcare POA is so crucial and probably also giving them permission to not go by your word at the time if you are forgetting other circumstances the POA feels would be impacting your decision.

I hope my train of thought is clear. I have bad allergy brain fog today and am not tracking well.
Circ, your brain with allergy fog works great and your train of thought did not derail. :lol:

I thought it would be helpful to go to the Netherlands Supreme Court ruling and quote key principles here, since I think they could/should be useful to groups like Compassion & Choices-Dementia Healthcare Provision that advocate for end-of-life choices in the U.S.

Many thanks to Google translate for this excerpt; the bolded sections are my doing: Doctor may comply with a written request for granting euthanasia in people with advanced dementia
[T]he Supreme Court sets out the principles for the possibility for a doctor to comply with a written request for euthanasia from a patient suffering from advanced dementia. In short, the main principles include the following.

The law allows a person to record a request for termination of life in a written statement for the situation in which he no longer has the ability to express his will. A physician may comply with such a request if all the requirements of the law regarding euthanasia are met, including the requirement that there be hopeless and unbearable suffering. The doctor is then not punishable. This also applies if the inability to express a will is caused by advanced dementia. In that case, too, all requirements set by law regarding euthanasia must be met. These requirements ensure that the doctor acts carefully. Therefore, they must be completed here in a way that does justice to the particularity of cases of advanced dementia.

Even if it is clear that the request is intended for the situation of advanced dementia and that situation has now been reached, so that the patient is no longer able to form and express a will, there may be circumstances that cannot be followed up on request. This may concern, for example, behavior or verbal statements by the patient from which it must be deduced that the patient's actual condition does not correspond to the situation envisaged in the request.

In particular, the requirement that there should be unbearable suffering requires special attention in cases of advanced dementia. Legal history has shown that this may primarily be the case of physical suffering of the patient as a result of another physical condition. However, even if another condition is missing, there may be signs that the patient is suffering from advanced dementia to such an extent that his suffering can be considered unbearable.

As is already customary in practice, in cases involving the termination of life of a patient with advanced dementia, there is reason to consult not one but two independent doctors beforehand on whether the request can be granted.
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Re: Dutch Woman With Dementia Euthanized Against Her Will. The Doctor Was Just Cleared Of Wrongdoing.

Postby circular » Sat Apr 25, 2020 1:55 pm

NF52 wrote:Circ, your brain with allergy fog works great and your train of thought did not derail. :lol:

I thought it would be helpful to go to the Netherlands Supreme Court ruling and quote key principles here, since I think they could/should be useful to groups like Compassion & Choices-Dementia Healthcare Provision that advocate for end-of-life choices in the U.S.

Thanks for both NF52!
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Re: Dutch Woman With Dementia Euthanized Against Her Will. The Doctor Was Just Cleared Of Wrongdoing.

Postby babl » Fri Jun 05, 2020 4:11 pm

Last week we moved my mom into a memory care facility. Her Alzheimer's is moving along at a pretty fast clip, just like with her mother (my grandmother). My grandma's passing was truly horrifying to witness. I see my mother going through the same stages at the same rate. I understand that for some, dementia and Alzheimer's can result in a "happy period" toward the end, where all is forgotten and any suffering or anxiety disappears. This wasn't the case for my grandmother. We'll see how my mom fares. Considering my family history of this disease, and my great desire to avoid the horrible death I witnessed (and may witness again in the not-too-distant future with my mother), not to mention my desire to not burden my family with the huge cost of managing the disease in the end stages, a few months ago I decided to become a member of The Final Exit Network. Unfortunately, currently in the US the "Death with Dignity" laws don't apply to those with dementia. One has to be of sound mind and body and be given 6 months or less to live in order to qualify for a physician-assisted death. Hopefully the laws will be modified at some point. I plan to do what I can to advocate and lobby for change. I also feel it's important to mention, I will not follow through with a planned death unless my family is on board with me.

In the meantime, I'm putting together my Advanced Directive with help and guidance from various sources to word it properly and thoroughly. Glad to see there's a Wiki here with help and resources for those of us who would like to choose this path. Thank you! It's not the right choice for everyone, but I feel that in my case, it's best.

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Re: Dutch Woman With Dementia Euthanized Against Her Will. The Doctor Was Just Cleared Of Wrongdoing.

Postby circular » Fri Jun 05, 2020 6:35 pm

babl wrote:It's not the right choice for everyone, but I feel that in my case, it's best.

This story about a man in Seattle, who legally chose what day he wanted to die and then had his life during the weeks ahead filmed, won an Edward R. Murrow award for video. It might interest you and others. In this case he had his full wits about him and dementia didn't appear to be an issue, but it's thought provoking.
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