Thursday, August 5, 2004

EUTHANASIA IN HOLLAND Reuters: "In face-to-face interviews with 410 physicians in the Netherlands, 52 percent said that in the previous two years they had administered sedating medications while withholding fluids and nutrition for patients nearing death. Hastening death was partly the intention of the physician in 47 percent of the terminal sedation cases and the explicit intention for 17 percent. According to their report in the Annals of Internal Medicine, Dr. Judith A. C. Rietjens from Erasmus Medical Center in Amsterdam, and colleagues, found that physicians discussed the use of terminal sedation with the patient in 59 percent of cases and with patients' relatives 93 percent of instances. The decision to forgo food and water was discussed with the patient in only 34 percent of cases. While physicians surveyed 'almost always' discussed the use of terminal sedation with relatives, Rietjens and colleagues found it 'remarkable' that general practitioners often did not consult other physicians or caregivers and rarely sought the advice of specialists in palliative care or pain management. This concerns Dr. Muriel R. Gillick from Harvard Medical School in Boston, who notes in an editorial that 'although state-of-the-art palliative care should substantially control pain in 90 percent of cases', pain was the most common reason for turning to terminal sedation. 'That the Dutch physicians seldom used palliative care consultation underscores the concern that they may have used terminal sedation when a less drastic approach existed,' Gillick writes." I fully agree with Dr. Gillick. From personal experience I know that it is enough for one nurse (who does not personally know the patient) to mention to the physician that the patient is having pain, for a parcel to arrive from the chemist with heavy morphiates without any information leaflets. If you ask for such a leaflet you immediately understand that when administered the patient will die in a couple of hours. I think this is inadmissible. No information, or wrong information, is given by doctors; nothing is done to ease the pain by other means (because the health insurance will not pay for this in the case of terminal patients). And in many cases the doctors disregard the wishes of the patients and their families. 1:19:33 PM

© Copyright 2004 Hetty Litjens.