Euthanasia on islands is complex, says Minister

THE HAGUE--Implementing euthanasia legislation in Bonaire, St. Eustatius and Saba as of October 10, 2012 is a "complex assignment," according to Dutch Minister of Public Health, Wellbeing and Sports Edith Schippers.

The regulations and meticulous application and reviewing of euthanasia are especially cumbersome, when considering that there will only be an estimated two or three cases per year on the three Dutch public entities.
Member of the Dutch Parliament's Second Chamber Cynthia Ortega-Martijn of the Christian Union (CU) is questioning whether it is all worth the effort. "Other things on the islands are more urgent. The Minister should take the time to implement this in a very careful way." She pointed out that people on the islands had a different opinion on life and death than people in The Netherlands.
Ortega-Martijn wondered whether doctors would be willing to cooperate in implementing this legislation, which the Dutch Parliament basically has forced on the islands. "In The Netherlands there are also doctors who refuse this, on grounds of conscience. What will the Minister do if doctors refuse on the islands? Or when there is no medical examiner? Will the patient then be put on a plane to The Netherlands?"
Minister Schippers sent a letter to the Second and First Chambers on Wednesday, in which she explained the procedure and regulations of euthanasia on the islands. She informed Parliament that euthanasia was a sensitive issue with very limited support on the islands.
For this reason, it is extra important that the implementation takes place with "extreme caution," so medical doctors will be able to handle conforming to the strict precision requirements in the law and that he or she will be reviewed as such.
The Minister defined the specific procedure which includes a number of steps in case a patient has clearly indicated that he or she no longer wants to live and suffer. The doctor who has performed euthanasia must immediately notify a medical examiner, who will review the body and determine the exact cause of death. Only after that, the Prosecutor will give permission for burial or cremation.
The reports of the doctor, medical examiner and an independent doctor will be sent to the Regional vetting committee in The Netherlands. The committee for the province North Holland is willing to handle the cases from the Caribbean Netherlands. The Prosecutor will be informed if the committee finds that the doctor didn't act in accordance with the requirements.
Doctors in the islands have limited knowledge in the area of palliative care and euthanasia. That is why the VUmc and AMC hospitals of Amsterdam will shortly start an educational course for all doctors in the islands. This module will include the broad area of palliative care, medical decisions surrounding euthanasia and terminal care.
A doctor has to consult an independent colleague in case of euthanasia. Bonaire already has several doctors who have been trained for this, at a specialised Dutch consultative organisation, but this is not the case in St. Eustatius and Saba. "A practical solution will have to be found for this by, for example, consulting a doctor from outside," stated Schippers.
The Executive Councils in the islands will have to appoint a medical examiner, who can examine the body of a euthanised person. Bonaire has indicated that it will be able to appoint such person before the law goes into effect on October 10, 2012. There are some practical problems in St. Eustatius and Saba, for which a solution will be sought together with the Dutch Ministry of Public Health, Wellbeing and Sports VWS.
The Minister admitted that euthanasia is a sensitive issue on the islands and that is why it is important to properly involve and inform the people on the implementation of this legislation. She has asked the Dutch Public Health Service GGD, if possible together with the Kingdom Service Caribbean Netherlands RCN, to inform the people. "Proper information will prevent much uncertainty and lack of understanding," she stated.

(The Daily Herald)

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