31-5-2006
No other reasonable alternative
The doctor and the patient must be convinced that there is no alternative other than euthanasia or assisted suicide. This criterion makes it clear that the decision-making process is a matter involving both patient and doctor.
The main priority is the care and treatment of the patient, and for his/her suffering to be discussed and relieved as far as possible. The question is whether there are prospects for improving the patient’s situation within a reasonable time and whether the results of treatment warrant the burden it will place on the patient.
The provision of good medical treatment (including palliative care) is the essence of the doctor-patient relationship. Euthanasia is the final resort and only becomes an issue once the patient and doctor are convinced that there are no longer any realistic prospects for treatment. That does not mean to say that every possible type of palliative treatment must be tried. Some forms of treatment have side effects which are difficult for patients to tolerate. Radiotherapy can have such serious side effects that the disadvantages of treatment outweigh the advantages. Some patients refuse further palliative treatment – in the form, for instance, of higher dosages of morphine – because they absolutely do not want to become drowsy or lose consciousness.
There may therefore be good reason to refrain from further treatment. If treatment is refused, the committees decide on a case-by-case basis whether there was ‘no other reasonable solution’. Because doctor and patient come to a joint decision, doctors are expected to indicate in their report why the patient’s refusal of an alternative treatment was reasonable in that situation.
