31-5-2006
Consultation
The consultation criterion requires that the doctor consult at least one other physician who has no connection either with him or with the patient. This physician must have seen the patient and given a written opinion on whether the due care criteria have been observed.
The KNMG paper on euthanasia published in 2003 emphasised that this physician must be an independent colleague, neither a member of the same practice or partnership, nor a relative, intern or any other doctor in a subordinate position to the attending physician. The consulting physician must familiarise himself with the patient’s medical situation and his/her request by visiting the patient and if necessary examining him/her.
Nor can a doctor act as independent physician if he is treating the patient, has a personal relationship with the patient or has treated the patient as a locum. Even the appearance of a connection must be avoided.
The independent physician’s report, containing a description of the patient’s condition at the time of the visit and of his/her wishes as expressed at that time, is essential to the committee’s assessment. He must also say how he determined whether all the due criteria had been fulfilled, and give reasons for his conclusions. He should also describe explicitly his relationship with the patient and the attending physician.
The independent physician is responsible for his own report. This does not alter the fact that the attending physician (who reports the euthanasia or assisted suicide) has ultimate responsibility for ensuring that all the due care criteria have been complied with. This also means that the attending physician has to ascertain whether the report written by the independent physician is of sufficient quality.
The KNMG’s Euthanasia in the Netherlands Support and Assessment Project (SCEN) trains doctors to provide a second opinion in cases of euthanasia. Every aspect of the consultation – medical, ethical and legal – is dealt with during the course.
