A psychiatrist must answer to the regional disciplinary committee on Tuesday about the implementation of euthanasia in two patients with a psychiatric illness. The Health and Youth Care Inspectorate filed a complaint against her after the RTE (Regional Euthanasia Testing Committees) ruled in both cases that the psychiatrist did not meet the due care criteria.
In both cases, the RTE found that the psychiatrist, working at the Expertise Center for Euthanasia, did not meet the due care criteria with regard to requesting a second opinion from a psychiatrist. In the case of euthanasia requests that arise from suffering as a result of a psychiatric disorder, the executing physician must, according to the guidelines, handle the request with extra caution. In addition to the regular (SCEN) consultant, an independent psychiatrist must always be consulted. In the first case, on which the RTE published an opinion in March 2022, the executive psychiatrist brushed aside her colleague’s conclusion that the patient was not mentally competent with regard to his euthanasia request. In the second case, on which the RTE published an opinion in October 2022, the executing physician did not consult a psychiatrist at all, but based herself on a two-year-old report that was not drawn up in the context of a euthanasia process.
When the RTE judges that a doctor has acted carelessly in a euthanasia process, a standard report is made to the Health and Youth Care Inspectorate (IGJ) and the Public Prosecution Service (OM). It rarely happens afterwards that the IGJ submits a complaint to the disciplinary committee as a result of this. In the past ten years, this only happened in four cases. A well-known recent example is the case against a geriatric specialist, which became known as the ‘coffee arrest’ or ‘coffee euthanasia’. In each case, the physician involved received a warning or reprimand.
‘Euthanasia in cases of psychiatric suffering is still a controversial subject,’ says psychiatrist and lawyer Noortje van de Kerkhof in response to the upcoming session of the disciplinary tribunal. ‘Many doctors struggle with it and the room to deviate from guidelines is very limited. I think that many colleagues feel the need for further elaboration of the ‘limits of professional practice’ in this sensitive theme. As a professional group, we need statements like this for the further development of our working method when it comes to termination of life in cases of psychological suffering. That does not alter the fact that it is of course extremely stressful for this doctor; it is her actions that are now under the magnifying glass.’
In contrast to geriatric specialists in ‘coffee euthanasia’, psychiatrists no longer have to worry that they will also be prosecuted. According to an OM spokesperson, the first report was dismissed by the OM in April 2022 due to the lack of suspicion of a criminal offense. The second report was dropped in February 2023, because there is no legal and convincing evidence that a criminal offense has been committed. The press officer emphasizes that the fact that the Public Prosecution Service sees no evidence for a criminal offense does not alter the fact that a professional standard may have been violated.