After euthanasia of an incompetent patient with dementia, physicians will no longer be routinely summoned for a hearing by one of the Regional Euthanasia Review Committees (RTE). Coordinating RTE chairman Jeroen Recourt confirms this.
A letter submitted to Medisch Contact by general practitioner and SCEN doctor Hans van der Linde, on behalf of all twelve SCEN doctors working in Zeeland, prompted the RTEs to reconsider the policy, says Recourt. In this letter, Van der Linde stated that the obligation to appear after euthanasia for an incompetent patient with dementia is ‘burdensome’ for doctors and influences their ‘willingness to euthanasia’. Partly for this reason, they would rather hold off the boat.
According to Recourt, it was initially necessary to call all operating doctors by default. Recourt: ‘Since the guide ‘Written advance directive for euthanasia’, which was published in December 2015 and was drawn up by a working group with members of VWS, Security and Justice and the KNMG, more scope has been created for euthanasia in mentally incompetent patients with dementia. But the RTEs themselves still had many questions and ambiguities about this type of casuistry. These have crystallized through the current experience and the judgment of the Supreme Court on euthanasia for a patient with advanced euthanasia (also known as the coffee judgment, ed.).’
Reports of euthanasia in advanced dementia will from now on be treated like all other reports, says Recourt. ‘If there are specific questions about a case, the performing physician and sometimes also the SCEN physician are called upon to provide further explanation in writing or in an interview. In ’22 this happened 18 times in writing and 28 times in a conversation. We will no longer call doctors as standard after euthanasia in advanced dementia, but I expect that it will still happen in many of the cases. Incidentally, it doesn’t happen that often at all; in ’22, six reports involved euthanasia in a mentally incompetent patient with advanced dementia. 282 reports concerned dementia patients who were still mentally competent.’
According to Recourt, not all doctors experience it as annoying when they are called for an explanation at the RTE. Recourt: ‘It can help doctors to reflect with us on a complicated case. I think the burden and any uncertainty that it can entail is more related to the complexity of the matter than to the fact that they have to come to us for an explanation.’
Van der Linde says he is positive about the decision of the RTE. ‘It is gratifying to see that they are responding to our call to pay more attention to the position of euthanasia physicians. That is something that is really lacking at the KNMG and RTE, I think.’
