den Hartogh Govert A
Universiteit van Amsterdam, faculteit Geesteswetenschappen, afd. Wijsbegeerte, Amsterdam.
Contact:
Ned Tijdschr Geneeskd. 2024 Aug 26;168:D8216.
The most controversial issue in the Dutch euthanasia practice concerns the performance of euthanasia in a case of a patient in an advanced state of dementia on the basis of a request that is laid down in an advance directive. This is particularly controversial when such a patient, although lacking decisional capacity on the matter, shows signs of a wish to live. In two important verdicts of April 21 2020 the Dutch Supreme Court has ruled that a request that has been made competently cannot be revoked incompetently. In this comment I consider two recent documents from Dutch professional organisations that are contrary to these decisions, in particular a guideline stating that on a proper understanding of decisional capacity the expression of a wish to live of a demented person, however inarticulate, should always be considered to be made competently.
荷兰安乐死实践中最具争议的问题涉及根据预先指示中的请求，对处于晚期痴呆状态的患者实施安乐死。当这样的患者尽管在此事上缺乏决策能力，但仍表现出求生愿望时，这一问题就特别具有争议性。在2020年4月21日的两项重要裁决中，荷兰最高法院裁定，在具备行为能力时做出的请求，不能在丧失行为能力时被撤销。在这篇评论中，我考量了荷兰专业组织最近发布的两份与这些裁决相悖的文件，特别是一份指南，该指南指出，在正确理解决策能力的情况下，痴呆患者表达的求生愿望，无论多么含糊不清，都应始终被视为是在具备行为能力时做出的。
