Living wills are often too old to sanction euthanasia: research

A large number of the euthanasia declarations signed by people in the Netherlands are useless because they have not been regularly updated, according to research by a Dutch family doctor.

Matthijs van Wijmen has followed thousands of people who have set down their wish to die by euthanasia should they become senile, incapacitated or terminally ill.

However, doctors cannot perform euthanasia on the basis of an old declaration, and fewer than half of people with a living will update it, Van Wijmen told Trouw on Wednesday.

Anyone can draw up a living will but the two Dutch voluntary euthanasia societies publish standard versions. However, just 42% of NVVE and 28% of NPV members had discussed their wishes with their family doctor within the six year period of the research, meaning their declarations were likely to be considered void, Van Wijmen found.

There is no official guideline for determining how often a living will should be updated. However, earlier this year a doctor was reprimanded by the euthanasia regulatory body because she had carried out euthanasia on someone whose living will was five years old.

‘This one of the most pressing issues,’ an NVVE spokesman told Trouw. ‘We are in talks with doctors about coming up with guidelines.’

Rules

In 2016, the justice and health ministries relaxed the guidelines for performing euthanasia on people with severe dementia a little so that patients can be helped to die even if they are incapable of making their current feelings known.

However, they do have to have signed a euthanasia declaration with their family doctor before they become too seriously ill to be considered for help in dying.

Euthanasia is legal in the Netherlands under strict conditions. For example, the patient must be suffering unbearable pain and the doctor must be convinced the patient is making an informed choice. The opinion of a second doctor is also required.