Chapter XXIII: Doctors Who Practice Euthanasia

Even in the early days some observers warned that euthanasia was not just another procedure added to the medical practice but would change the physician's whole attitude and also their professional performance. The predictions proved right. Handling the Facts of the Case. Dutch doctors are excellently trained professionals and many of them are strikingly talented individuals. Family physicians impress the specialists by their ability to report from memory every patient's medical history in every detail. And yet two series of cases have been published, one by Innemee from the Dutch Patients' Association,33r and the other by myself, (338) showing factual errors, misrepresentation of the facts, and negligence on the part of doctors in their attempts to justify euthanasia. A family physician phoned me three times to request that I allow his patient to die. The man had suffered cardiac arrest in the street, and had been resuscitated by passers by and transported to my intensive care unit. The family physician argued that the patient also had lung cancer and that the family wanted euthanasia. Both statements proved false. Six months before, the family physician had indeed suspected patient of lung cancer and had referred him to a chest specialist; the specialist ruled out cancer. The patient's two daughters (he had no other family) categorically denied that they had requested euthanasia; they stated that they had not spoken about their father to the family physician or any other doctor. When transferring to me an acutely ill patient with myocardial infarction and pulmonary edema, an internist colleague of mine tried to persuade me to let the patient die he was a widower without family, entirely alone in the world. Of course, that argument had no influence on my actions and also proved untrue. This patient, Mr. T, was under my care for the next eight years and always came to the outpatient clinic accompanied by his loving sons, daughters, and in-laws. After examining a woman patient of mine, the consulting neurologist wrote in his opinion: this elderly man is deeply comatose and, in my view, should not be resuscitated again. Having examined the patient, doctor still did not know whether the patient was a man or woman, but he did know that person's life should not be prolonged. To be sure, the patient's sex had no bearing on the conclusion; but the incident showed that decisions about life and death could be made in a distracted state of mind. The actions of Dr. W (339) were not marked by scrupulousness, to put it mildly. This doctor, who routinely put patients to death without their consent or knowledge, considered it unnecessary personally to examine the patient before making such a decision. If, when making his (quick) ward rounds, he had the impression that a patient was in critical condition, he would ask the nurse: Ishij euthanasieachtig? [Is he suitable for euthanasia?] The nurse's answer would decide the patients fate. In the case cited in Chapter XXIV, Dr. W ordered that the patient be given a lethal injection though nobody knew what was wrong with the patient (if anything). The patient was in a dimmed state during the ward round because he had been stupefied by valium (diazepam), which that same Dr. W had prescribed a few days before. Dr. W had forgotten that he had prescribed valium and it did not occur to him that might have been the cause of the patient's stupefaction. He did not even glance at the patient's chart which would show that the patient was receiving the drug. That's how scrupulously the doctors proceeded who attempted to subject patients to euthanasia. In my entire medical career I have never encountered such a series of crude errors and transgressions as those committed by doctors in their rush to euthanasia: lies, distortion of fact, impaired powers of observation and concentration (to mistake a woman for a man! …