Heman-WMA EoL Presentation Vatican-Nov2017

23-11-17
1
Euthanasia in the Netherlands:
balancing autonomy and compassion
Dr René Héman
Chairman, Royal Dutch Medical Association (KNMG)
Vatican City – Euthanasia in the Netherlands: balancing autonomy and compassion
16 November 2017
The Physician’s Pledge (Declaration of Geneva)
As a member of the medical profession:
I solemly pledge to dedicate my life to the service of humanity;
The health and well-being of my patient will be my first consideration;
I will respect the autonomy and dignity of my patient;
• When can euthanasia be a justifiable act?
• Legislation and practice on euthanasia in the Netherlands
Different perspectives, same vocation
Vatican City – Euthanasia in the Netherlands: balancing autonomy and compassion
16 November 2017
• Euthanasia is still a punishable offence under the Dutch Penal Code
• 2002: Dutch Termination of Life on Request and Assisted Suicide Act passed
• Bottom-up: Codification of decades of discussion in society and medical profession
• It features the Dutch: history of striving for freedom, free will and conscience, tolerance
The Dutch Termination of Life-Act: what and when?
Vatican City – Euthanasia in the Netherlands: balancing autonomy and compassion
16 November 2017
1. Voluntary and well-considered request
2. Unbearable suffering and no prospect of improvement
3. Patient is informed about the situation he/she is in and about the prospects
4. Conviction that no other reasonable solution for the patient’s situation is available
5. One other independent physician is consulted
6. Termination of life or assisted suicide performed with due care
The 6 due care requirements for euthanasia
Vatican City – Euthanasia in the Netherlands: balancing autonomy and compassion
16 November 2017
• The principle of respect for persons / respect for autonomy
• Acknowledgement of the autonomy and dignity of persons (cf Declaration of Geneva)
• Right to autonomous choice to end life: NO right to be assisted by others
• No right on euthanasia for patients, no obligation for physicians to perform euthanasia
• The principle of compassion
• ‘
Moral justification for euthanasia
Vatican City – Euthanasia in the Netherlands: balancing autonomy and compassion
16 November 2017
• Appropriate, accessible, affordable End-of-Life-Care for all people is crucial
• Increase of palliative care in the Netherlands the last years
• Euthanasia can be the last resort in the sequence of End-of-Live-Care
• is not a therapeutic intervention nor ‘regular medical care’
• does not undermine the trust in the physician-patient relationship
• shows respect for patient’s autonomy, compassion, does not force care upon patient
The need for appropriate End-of-Life-Care
Vatican City – Euthanasia in the Netherlands: balancing autonomy and compassion
16 November 2017
23-11-17
2
• Euthanasia is a complex and controversial issue: it is not regular care
• Is based on the principles of respect for persons/ autonomy and of compassion
• Justified if if due care requirements are met & appropriate End-of-Life-Care is available
• Transparancy and supervision always needed
Different perspectives, same vocation
Conclusion
Vatican City – Euthanasia in the Netherlands: balancing autonomy and compassion
16 November 2017
Thank you for your attention
Vatican City – Euthanasia in the Netherlands: balancing autonomy and compassion
16 November 2017