A voluntary and well-considered request is considered a condition sine qua non for euthanasia.
Among the conditions, patients must face a future of unbearable, interminable suffering and must make a voluntary, well-considered request to die.
Euthanasia is commonplace in the Netherlands, and the legal criteria are utterly subjective: "unbearable suffering," "due care" and, fuzziest of all, especially in cases of dementia or mental illness, a "voluntary, well-considered request". As bioethicists David Miller and Scott Kim of the National Institutes of Health note in a recent paper, "Dutch physicians. . .
Unbearable and hopeless suffering, no reasonable acceptable treatment alternative, a voluntary and well-considered request and consultation of an independent physician are among the compulsory criteria for EPAS [ 17].
Likewise, a clear distinction should be made between suicidality (in thoughts and behaviour), which is symptomatic of (and/or triggered by) a number of psychiatric disorders, and a well-considered euthanasia request, which includes a patient's statement that his or her suffering is entirely unbearable, and that available treatment and medical assistance has been found to be inadequate.
3. Other includes: Family was convinced that the request was well-considered, patient's request had been judged by another physician, availability of an advance directive, patient always wanted to decide for himself.
Under the new law, passed in April, doctors can still be prosecuted if they fail to follow strict rules, which say that an adult patient must make a voluntary, well-considered and lasting request to die.
The most frequently mentioned reasons for not granting the request were: the patient died before the request could be fulfilled (39%), the request was not well-considered (18%), suffering was not unbearable (16%), and the patient withdrew the request (10%).
However, physicians did not uniformly argue why they thought the request was well-considered and review committees rarely asked for additional information about this requirement.
Physicians reported that the patient's request had been well-considered because the patient was clear-headed (65%) and/or had repeated the request several times (23%).
A previous study showed that not granting a request for euthanasia or physician-assisted suicide is frequently due to the request not being well-considered according to the physician [ 22].
