Terminal sedation: confusion in the Netherlands

Publié le 21 Mar, 2017

The Health Care Disciplinary Council (RTG) at the Hague has just reprimanded a geriatric physician “who did not consider it appropriate to sedate a 102 year-old patient who requested it”.


The doctor acknowledged the fact that his patient had expressed the “desire to no longer live”, but she was “calm, slept well and responded well to doses of morphine”, without presenting any “refractory physical symptom”. The patient’s family complained after her death due to natural causes, “arguing that a desire to die was a refractory symptom and, on that basis, doctors could not refuse sedation”.


In its recent decision, the Council stated that “the doctor should have taken into consideration the mental suffering of staying alive when the patient wanted to die”. This therefore infers that “if a person expresses a wish to die, this can be qualified as a ‘refractory symptom’”.


However, on hearing the case, the Disciplinary Board of the Dutch Federation of Physicians (KNMG) “pointed out that the decision to plunge a patient into a state of unconsciousness through sedation is not up to the family or the patient, but is taken by the doctor(…). Therefore, it is not a case of automatically granting sedation to any patient who requests it”.

Institut Européen de Bioéthique (9/03/2017)

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