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Matters of life and death.pdf - Feature euthanasia Matters...

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Two months after qualifying as a general practitioner (GP) in the Netherlands, Rik Haarmans carried out euthanasia for the first time. His patient had colorectal cancer and had always said he wanted to die when he was no longer able to get out of bed. For the young doctor, it was a tough decision to make, with serious legal implications, because in 1983, when Haarmans was asked by his patient to end his life, physician-assisted dying was still illegal. ‘It was a covert operation,’ recalls Haarmans. ‘You went to the back door of the pharmacy to pick up the medication. The patient’s family couldn’t discuss the euthanasia with anyone.’ There were no guidelines in place to assist doctors carrying out euthanasia. ‘I was worried the first time that the dose wouldn’t be the right amount,’ Haarmans recalls. ‘When I was driving home afterwards, I thought the phone might ring and I’d be told the patient had woken up.’ Since 2002, the Termination of Life on Request and Assisted Suicide Act has laid down a strict set of criteria which the doctor must meet to avoid prosecution. The patient must have full mental capacity when making the request, and the suffering must be irremediable and unendurable. The law does not specify that the condition must be terminal. Complex wishes Dutch GPs are receiving more and more euthanasia requests from patients with psychiatric conditions and dementia. Last year, euthanasia was carried out on 56 patients with a psychiatric condition, a 37-per-cent increase compared with 2014. Doctors helped 109 dementia patients end their lives in 2015. The requests of non-terminal patients who wish to die are complex, according to Coen Gerretsen*, a GP in Rotterdam. ‘The suffering of a terminal cancer patient is visible. I have only ever carried out euthanasia on patients with a terminal illness.’ He currently has a patient with early onset dementia who wants to die when her condition progresses.
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