31-5-2006
Request
The basic precondition for justifiable termination of life or assisted suicide is the patient’s explicit request. This must be voluntary and well-considered. A request made on impulse in a highly emotional state may not be complied with. For a request to be voluntary, no pressure or influence must have been exercised on the patient. Although family and often nursing staff and caregivers are involved in the request, they do not have to agree with it. The patient’s wishes are paramount. A request is well-considered if the patient has a full understanding of his/her illness: the diagnosis, prognosis and treatment options.
The Act does not require the request to be made in writing, but from the point of view of evidence a written document is preferable. A written request is only indispensable if as a result of the progression of the disease, the patient is no longer capable of expressing his/her wishes. Under the Act, patients may draw up an advance directive which is valid provided they were capable of expressing their will at the time it was written. Before complying with such a directive, the doctor must first ensure that all the other due care criteria have been fulfilled.
Request made by a minor
Only patients who are capable of expressing their wishes may request euthanasia or assistance with suicide and they must do so in person. This rules out requests from parents or a legal representative. Under the Act, minors aged twelve or over may however make such a request. In line with existing rules on medical procedures relating to minors, the Act distinguishes between two age categories. Patients between the ages of twelve and sixteen need the consent of their parents or guardian. Sixteen and seventeen-year-olds can in principle make an independent request, although their parents or guardian must be involved in the decision-making process.
