The unfeasibility of requests for euthanasia in advance directives.
In April 2002 a new law regarding euthanasia came into effect in The Netherlands. This law holds that euthanasia remains a criminal offence unless it is (1) performed by a physician who (2) acts according to six specified rules of due care and (3) reports the case to a review committee. The six rules of due care are similar to those of the previous regulation and are largely based on jurisprudence. Completely new, however, is the article concerning a competent patient who has written an advance directive requesting euthanasia under certain circumstances. The law stipulates that a physician may act according to that written request, as long as he or she fulfils all other rules of due care. The author defends the view that these requests are neither feasible nor ethically justifiable, and presents both moral and practical arguments for this, claiming that for consistency reasons one cannot act on the basis of a written statement and fulfil the other rules of due care at the same time. The author also examines a difficult case of a demented, severely depressed woman who had written a living will requesting euthanasia before she became demented.
Julius Center for Health Sciences and Primary care, University Medical Center, Utrecht, 3508 GA Utrecht, The Netherlands. j.j.m.vandelden@umcutrecht.nl
J J M
JJ
van Delden
D016223:Advance Directives / Q000941:ethics* / Q000331:legislation & jurisprudence; D000368:Aged; D003704:Dementia / Q000150:complications; D004645:Empathy; D005065:Euthanasia / Q000941:ethics* / Q000331:legislation & jurisprudence; D005260:Female; D006801:Humans; D007258:Informed Consent / Q000941:ethics; D016743:Mental Competency; D009014:Morals; D009426:Netherlands; D010148:Intractable Pain / Q000175:diagnosis; D010166:Palliative Care / Q000941:ethics; D026684:Personal Autonomy; D010817:Physician-Patient Relations; D017410:Practice Guidelines as Topic