A physician in the Netherlands provided active euthanasia to a patient who lacked capacity at the time. This is remarkable. And, hopefully, it is a sign of a trend toward allowing more actively- (and not just passively-) hastened death. Currently, in almost every jurisdiction where physician aid-in-dying is legal, it is permitted only in response to a contemporaneous request from a patient with the relevant decision making capacity.
The advance decision for active euthanasia was respected in this case because the patient had made it clear from the beginning to both her doctor and her nursing home that she wanted euthanasia. The prospect of losing her independence and her children no longer recognize her was a nightmare. She had it in writing in an advance directive. And she repeated her desire to her regular doctor, with whom she had a close relationship. (Volksrant)
The Netherlands euthanasia review commission found that the physician had acted appropriately. He had, from many conversations with the patient, a very good picture of what she regarded as unbearable suffering. This was confirmed by the patient's living will.
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