ORIGINAL RESEARCH

 

Eutanasie as vrywillige keuse deur persone met demensie, met verwysing na die praktyk in Nederland 'n voorlopige teologies-etiese beoordeling

 

Life to the bitter end: Euthanasia as voluntary choice by persons with dementia, with reference to the practice in the Netherlands - a preliminary theological-ethical evaluation

 

 

Adriaan L. Rheeder

School for Ecclesiastical Studies, Potchefstroom Campus, North-West University, South Africa

Correspondence

 

 

---

OPSOMMING

Vanaf die 1970s blyk dit dat eutanasie op aanvraag in Nederland toegepas word. In 2002 word die praktyk van eutanasie op versoek gewettig. Wanneer daar aan sekere sorgvuldigheidsvereistes voldoen word, word eutanasie as wettig beskou. Eutanasie op versoek word die meeste op terminale kankerpasiënte uitgevoer. Vanaf 2004 is die neiging om eutanasie op versoek van pasiënte met vroeë demensie uit te voer. Verskeie persone het ook 'n lewende testament opgestel waarin eutanasie versoek word indien demensie sou ontwikkel. Die doel van hierdie artikel is 'n voorlopige beoordeling van hierdie praktyk in die lig van die gereformeerde etiek. Uit die studie wil dit voorkom asof die praktyk van eutanasie aan pasiënte met demensie in die algemeen nie aanvaarbaar is nie. Hierdie artikel beredeneer voorlopig dat die Skrif nie vreemd staan teenoor die moontlikheid van 'n uitsondering onder bepaalde omstandighede nie.

---

ABSTRACT

Euthanasia on request has been applied since the 1970s in the Netherlands. In 2002, the practice of euthanasia on request was legalised. When there is certainty that 'rules of due care' are satisfied, euthanasia is regarded as legal. Most euthanasia on request is executed on terminal cancer patients. From about 2004 the trend is found that euthanasia on request is performed to patients with early dementia. Several persons also have a living will in which euthanasia is requested if dementia develops. The purpose of this article is to preliminary judge this practice in the light of the reformed ethics. From this study it would appear that the practice of euthanasia to patients with dementia in general are not acceptable. This article argues provisionally that Scripture is not strange to the possibility of an exception under certain circumstances.

---

 

 

“Full text available only in PDF format”

 

 

Literatuurverwysings

Andersen, S. & Hallamaa, J., 1995, 'Euthanasia: A letter to a nurse on death and dying', in V. Mortensen (ed.), Life and death: Moral implications of biotechnology, pp. 64-70, WCC Publications, Geneva.         [ Links ]

Baldwin, R.C., 1995, 'Dementia', in D.J. Atkinson & D.H. Field (eds.), New dictionary of Christian ethics and pastoral theology, pp. 293-294, InterVarsity, Downers Grove.         [ Links ]

Bartelsman, M. & Jansma, J., 2010, 'Aantal euthanasiegevallen in 2009 sterk gestegen', in Nova Den Haag Vandaag, besigtig 07 Januarie 2010, by http://www.novatv.nl/page/detail/uitzendingen/7496/Aantal+euthanasiegevallen+in2009+sterk+gestegen#        [ Links ]

Barth, K., 1961, Church dogmatics: The doctrine of Creation, vol. 3, part 4, 2nd edn., transl. A.T. Mackay, T.H.L. Parker, H. Knight, H.A. Kennedy & J. Marks, T & T Clark, Edinburgh.         [ Links ]

Boer, T.A., 2002, 'Euthanasie: De regel achter de uitzondering' [Eutanasie: Die reël agter die uitsondering], Theologia Reformata 45(2), 126-144, besigtig 15 Desember 2009, by http://www.protestantsetheologischeuniversiteit.nl/uploadedDocs/medewerkerspagina/boer/Boer-Euthanasie.pdf

Boer, T.A., 2007, '"God" en euthanasie: Een persoonlijk theologisch commentaar' [Eutanasie: 'n Persoonlike teologiese kommentaar], Tijdschrift voor Gezondheidszorg en Ethiek 17(3), 62-66.

Boer, T.A., 2008, Euthanasie: Encyclopedie Protestant.nl., besigtig 15 Desember 2009, by http://www.protestant.nl/themas/gezondheid-en-gezin/opinies/euthanasie-enprotestantisme        [ Links ]

Boer, T.A., 2009a, epos, 11 Desember 2009, taboer@pthu.nl.         [ Links ]

Boer, T.A., 2009b, epos, 15 Desember 2009, taboer@pthu.nl.         [ Links ]

Boer, T.A. & Schroten, E., 1996, 'Life and death seen from a (Dutch) reformed position: A Calvinistic approach to bioethics', in L. Oestnor (ed.), Bioetikk og teologi, Rapport fra Nordisk teologisk nettverk for bioetikks workshop i Stockholm, 27-29 September 1996, pp. 31-51, Nordisk teologisk nettverk for bioetikk, Oslo, viewed 06 December 2009, from http://www.pthu.nl/taboer/        [ Links ]

Cameron, N.M. de S., 1995, 'Euthanasia', in D.J. Atkinson & D.H. Field (eds.), New dictionary of Christian ethics and pastoral theology, pp. 357-359, InterVarsity, Downers Grove.         [ Links ]

Charter for compassion, 2009, 'A call to bring the world together', viewed 15 December 2009, from http://charterforcompassion.org/        [ Links ]

De Bruyn, P.J., 1993, Die tien gebooie, Varia, Midrand.         [ Links ]

De Klerk, W., 1998, Die vreemde God en sy mense, Human & Rousseau, Pretoria.         [ Links ]

Dementia, 2002, Health Council of the Netherlands: Dementia to the Minister of Health, Welfare and Sport, viewed 06 December 2009, from http://www.gr.nl/sites/default/files/02@04NR.PDF        [ Links ]

Douma, J., 1992, De handreiking voor tien het Christelijk geboden leven, (De Tien Geboden, 4-6), Uitgeverij Van den Berg, Kampen.         [ Links ]

Douma, J., 1997, Medische ethiek, Kok, Kampen.         [ Links ]

Feinberg, J.S. & Feinberg, P.D., 1993, Ethics for a brave new world, Crosswaybooks, Wheaton.         [ Links ]

Gastmans, C. & De Lepeleire, J., 2009, 'Living to the bitter end? A personalist approach to euthanasia in persons with severe dementia' [Lewe tot die bitter einde, 'n Persoonsmatige benadering tot mense met ernstige demensie], Bioethics 10(1111), 1-9.

Geesink, W., 1931, Gereformeerde ethiek, deel 1, , Kok, Kampen.         [ Links ]

Grogan, G.W., 1995, 'Image of God,' in D.J. Atkinson, & D.H. Field (eds.), New dictionary of Christian ethics and pastoral theology, pp. 476-477, InterVarsity, Downers Grove.         [ Links ]

Harris, B., 1995, 'Suicide', in D.J. Atkinson & D.H. Field (eds.), New dictionary of Christian ethics and pastoral theology, pp. 825-826, InterVarsity, Downers Grove.         [ Links ]

Hertogh, C.M.P.M., De Boer, M.E., Dröes, R.M. & Eefsting, J.A., 2007a, 'Would we rather lose our life than lose our self? Lessons from the Dutch debate on euthanasia for patients with dementia' [Lesse uit die Nederlandse debat oor eutanasie vir pasiënte met demensie], The American Journal of Bioethics 7(4), 48-56. http://dx.doi.org/10.1080/15265160701220881

Hertogh, C.M.P.M., De Boer, M.E., Dröes, R.M. & Eefsting, J.A., 2007b, 'Beyond a Dworkinean view on autonomy and advance directives in dementia: Response to open peer commentaries on "Would we rather lose our life than lose our self?" Lessons from the Dutch debate on euthanasia for patients with dementia' [Lesse uit die Nederlandse debat oor eutanasie vir pasiënte met demensie], The American Journal of Bioethics 7(4), 4-6. http://dx.doi.org/10.1080/15265160701307696

Heyns, J.A., 1986, Teologiese etiek, deel 2(1): Sosiale etiek, NG Kerkboekhandel, Pretoria.         [ Links ]

Heyns, J.A, 1970, Die nuwe mens onderweg: Oor die tien gebooie, Tafelberg, Kaapstad.         [ Links ]

Hughes, J.C., 2001, 'Views of the person with dementia', Journal of Medical Ethics 27, 86-91. http://dx.doi.org/10.1136/jme.27.2.86        [ Links ]

Jochemsen, H., 2004, Recent developments in the euthanasia debate in the Netherlands, viewed 22 October 2009, from http://www.lindeboominstituut.nl/assetmanager.asp?aid=328        [ Links ]

Joubert, J. & Bradshaw, D., 2005, 'Population ageing and health challenges in South Africa', in K. Steyn & J. Fourie (eds.), Chronic diseases of lifestyle unit, Medical Research Council Technical Report, May 2006, pp. 204-219, viewed 01 December 2009, from http://www.mrc.ac.za/chronic/cdl1995-2005.pdf        [ Links ]

Nederland, Ministerie van Volksgezondheid, Welzijn en Sport, 2009a, Euthanasie - zorgvuldig van begin tot einde, besigtig 01 Desember 2009, by http://www.rijksoverheid.nl/documenten-en-publicaties/brochures/2010/01/15/euthanasie-zorgvuldig-van-begin-tot-einde.html        [ Links ]

Nederland, 2009b, Wet toetsing levensbeëindiging op verzoek en hulp bij zelfdoding, besigtig 24 Oktober 2009, byhttp://wetten.overheid.nl/BWBR0012410/geldigheidsdatum_24-10-2009        [ Links ]

Regionale Toetsingscommissies Euthanasie, 2005, Jaarverslag 2004, viewed 04 November 2009, from http://www.toetsingscommissieseuthanasie.nl        [ Links ]

Regionale Toetsingscommissies Euthanasie, 2006, Jaarverslag 2005, viewed 04 November 2009, from http://www.toetsingscommissieseuthanasie.nl        [ Links ]

Regionale Toetsingscommissies Euthanasie, 2007, Jaarverslag 2006, viewed 04 November 2009, from http://www.toetsingscommissieseuthanasie.nl        [ Links ]

Regionale Toetsingscommissies Euthanasie, 2008, Jaarverslag 2007, viewed 04 November 2009, from http://www.toetsingscommissieseuthanasie.nl        [ Links ]

Regionale Toetsingscommissies Euthanasie, 2009, Jaarverslag 2008, viewed 04 November 2009, from http://www.toetsingscommissieseuthanasie.nl        [ Links ]

Rietjens, J.A.C., Van Der Maas, P.J., Nwuteaka-Philipsen, B.D., Van Delden, J.J.M. & Van Der Heide, A., 2009, 'Two decades of research on euthanasia from the Netherlands: What have we learnt and what questions remain?' [Twee dekades van navorsing oor eutanasie van Nederland: Wat het ons geleer en watter vra bly staan?], Bioethical Inquiry 6, 271-283.http://dx.doi.org/10.1007/s11673-009-9172-3

Rurup, M.L., Onwuteaka-Philipsen, B.D., Van Der Heide, A., Van Der Wal, G. & Van Der Maas, P.J., 2005, '"Physicians" experiences with demented patients with advance euthanasia directives in the Netherlands' ['Geneeshere' se ervaring van pasiënte gevorderde demensie met 'n skriftelike versoek vir eutanasie], Journal of the American Geriatrics Society 53, 1138-1144. http://dx.doi.org/10.1007/s11673-009-9172-3

Rurup, M.L., Onwuteaka-Philipsen, B.D., Pasman, H.R., Ribbe, M.W. & Van Der Wal, G., 2006a, 'Attitudes of physicians, nurses and relatives towards end-of-life decisions concerning nursing home patients with dementia' [Die opinie van geneeshere, verpleegpersoneel en naby familie teenoor eutanasie as oorweging deur persone met demensie in inrigtings vir bejaarde sorg], Patient educ couns 61(3), 372-380. http://dx.doi.org/10.1016/j~.pec.2005.04.016

Rurup, M.L., Onwuteaka-Philipsen, B.D., Van Der Heide, A., Van Der Wal, G. & Deeg, D.J., 2006b, 'Frequency and determinants of advance directives concerning end-of-life care in the Netherlands' [Frekwensie en stipulasies in 'n skriftelike versoek deur pasiënte met demensie in Nederland], Social Science and Medicine 62(6), 1552-1563. http://dx.doi.org/10.1016Zj.socscimed.2005.08.010

Sorgdrager, W., 2008, 'De arts, de jurist, de ethicus en de dood' [Die geneesheer, die juris, die etikus en die dood], Trouw, letter & geest: 05 Jan., besigtig 15 Desember 2009, by http://www.trouw.nl/tr/nl/4324/Nieuws/archief/article/detail/1634257/2008/01/05/De-arts-de-jurist-de-ethicus-en-de-dood.dhtml

Taking Care, 2005, Ethical caregiving in our aging society: The president's council on bioethics, Washington, D.C., viewed 15 December 2009, from http://bioethics.georgetown.edu/pcbe/reports/taking_care/index.html        [ Links ]

Van Wyk, J.H., 1986, Gesindheid en gestalte, N.G. Kerkboekhandel, Pretoria.         [ Links ]

Vandrunen, D., 2009, Bioethics and the Christian life: A guide to making difficult decisions, Crossway, Wheaton.         [ Links ]

Vilela, L.P. & Caramelli, P., 2009, Knowledge of the definition of euthanasia: Study with doctors and caregivers of Alzheimer's disease patients, viewed 27 October 2009, from http://www.scielo.br/pdf/ramb/v55n3/v55n3a16.pdf        [ Links ]

White, H., 2008, British 'moralist' says dementia patients have a 'duty to die', viewed 24 October 2009, from http://www.catholic.org/international/international_story.php?id=29538        [ Links ]

 

 

Correspondence:
Riaan Rheeder
PO Box 62
Potchefstroom 2520
South Africa
Email: riaan.rheeder@nwu.ac.za

Received: 12 Jan. 2012
Accepted: 15 Apr. 2012
Published: 04 Oct. 2012