A geriatric doctor who helped a nursing home patient with severe dementia die is appearing in court on Monday in the first case of its kind in the Netherlands.

The doctor was given a formal reprimand earlier in 2018 after the case was highlighted by the regional euthanasia monitoring committee. ‘This case addresses important legal issues regarding the termination of life of dementia patients,’ the public prosecution department said in a statement at the time.

The case centres on a 74-year-old woman who had drawn up a living will some years before her admission to the nursing home, ‘but it was unclear and contradictory’, the department said.

‘Although the woman had regularly stated that she wanted to die, on other occasions she had said that she did not to want to die,’ the department said. ‘The department believes the doctor should have checked with the woman whether she still had a death wish by discussing this with her,’ the statement said.

‘The fact that she had developed dementia does not alter this, because the law also requires the doctor to verify the euthanasia request in such a situation.’

Although the public prosecution department stated it does not doubt the doctor in question acted in good faith, experts said it is important to bring the case to trial in order to clarify the legal rules and establish jurisprudence in cases of euthanasia for people with dementia.

‘This trial is a test case so and for that we need a suspect, health law professor Jaap Sijmons told broadcaster NOS. ‘We are getting older and many more people will get dementia. That means we will be facing more cases of this kind.’

Clarity

Nienke Nieuwenhuizen, chairwoman of the association of geriatric specialists, said that when euthanasia was legalised in 2002 no one had thought of dementia. ‘We could do with more clarity but the question is whether this case is going to bring it. It is mostly about the legal issues but there are ethical and spiritual dilemmas as well,’ she told the broadcaster.

Euthanasia for people with severe dementia is rare and last year two cases were reported. In total 144 people who were in the first stages of the disease were given euthanasia, compared to 12 a decade ago.

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.

Since the legislation was introduced in 2002, there have been a number of controversial cases, including a woman suffering severe tinnitus and a serious alcoholic.