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ASKING FOR EUTHANASIA IS ALWAYS DIFFICULT - Sep. 8 2007

Leo Enthoven

Bert van den Ende works as pastoral worker in the Albert Schweitzer hospital which has residences in Dordrecht, Sliedrecht and Zwijndrecht. Besides his regular work he is, already ten years, euthanasia consultant for four hours a week. Being a euthanasia consultant in a hospital is unique even for The Netherlands.

In a year he gets around 35 requests for euthanasia. He says the work is important because it is so very necessary. The request has impact on many different people and it gives satisfaction to accompany those who are involved. He has the responsibility to run the process properly and take care that there is taken care for those who stay behind. In a hospital the situation is different from the situation at home. More people are involved. The medical staff and the nursing staff may have different views. "We have
to take that into account".

From the moment a patient puts forward the subject of euthanasia Van den Ende is asked to assist. He gives the patient a leaflet about euthanasia, that you can talk about it, that euthanasia is feasible in the hospital, what the law is and when the euthanasia consultant comes into the picture. He also gives two forms: a prohibition of medical treatment and a request for euthanasia.

He points out the difference between the two, also the juridical difference. A physician has to comply with the request of no-treatment. In fact this request is a prohibition to treatment. The request of euthanasia is not a right to get euthanasia, it is a request. The physician is free to decide yes or no.

The consultant advises the patient to talk it over with their family, and to take the time. Usually it takes two weeks. When the forms are filled up and signed the discussion with the medical specialists takes place. The patient will tell what he considers as unbearable suffering.

The data of the Albert Schweitzer hospital are the following: In 2006 the number of patients who wanted to be informed was 35; 26 of them did not have a written living will as yet. Most requests (29) came from cancer patients. In the end two out of 35 requests have been granted. In the last six years there have been 207 requests for euthanasia -22 have been granted.

Reasons to ask for euthanasia were pain, fear for personal decay, unbearable suffering, suffocation. If no treatment was possible anymore, one didnt want to be utterly dependant or one did want to shortcut their way of the Cross. Reasons why euthanasia requests have not been granted: not eligible because the criteria of carefulness were not met (16 cases); the patient renounced his wish; the patient died while the procedure was still going on.

Ten years ago the procedure around euthanasia was not transparent. That did give commotion. There was no law on euthanasia (CdO: this law dates from 2002). An important aspect to install a euthanasia consultant was, and is, the support and relief of the nurses and medical specialists before, during and after the action. In the hospital there are 200 specialists.

It works to have a consultant, a liaison, one person who knows all the ins and outs, who has the expertise and can talk with all people involved: patient, family, nurses and physician. Now we have a Protocol Euthanasia in which everything is regulated. Other hospitals do have an ethical board who are involved in aspects of euthanasia. But a consultant is more approachable. Both patients and medical people know to whom to address themselves to.

Bert van den Ende, Roman Catholic pastoral worker, knows very well that his work as euthanasia consultant is on edge with the official view of the Roman Catholic Church. He says "it is only merciful to help people with those questions. The technical developments have overstepped the border between life and death. So we have the responsibility to help people when they come close to that border. It is only human".

Summary by Corry den Ouden-Smit

Published by NVVE