A Dutch doctor who euthanised a woman with severe dementia despite possibly showing signs of resistance acted within legal requirements, a court has ruled.
Prosecutors alleged that the 74-year-old woman had tried to get up as the doctor, named as Catharina A., administered a lethal injection and that she had to be held down by family members in order for the euthanasia to be completed.
The woman had stated in her will that her desire was for euthanasia to be carried out.
"I want to be able to decide (when to die) while still in my senses and when I think the time is right," she said.
Despite her advanced dementia, the doctor deemed that this prior declaration in the will was sufficient to meet the requirement for consent.
In January 2017, the Regional Euthanasia Review Committee disagreed but stopped short of sanctioning the doctor, saying that she had "acted in good faith".
Then in November 2018, the Dutch Public Prosecution Service decided to prosecute the doctor for murder, although it asserted that it was not seeking a custodial sentence in the case but rather legal clarity around the question of consent in cases of euthanasia involving dementia patients.
At a hearing this week, the court in the Hague ruled that the doctor had acted with due care and that verifying the woman's will to be euthanised had not been necessary because she was incapable of responding.
Delivering her verdict, Judge Mariette Renckens said that "all requirements of the euthanasia legislation" had been met.
"We believe that given the deeply demented condition of the patient the doctor did not need to verify her wish," the judge said.
Responding to the judgement, Dr Anthony McCarthy of the Society for the Protection of Unborn Children, questioned the interpretation of "due care".
"Euthanasia legislation in the Netherlands, as elsewhere, corrupts both medical and legal practice. Once such legislation is in place, pressure builds on vulnerable people to see their lives as no longer worth living," he said.
"In such a context 'proper care' can, apparently, come to mean, 'being held down and injected with lethal drugs'. Such actions have nothing to do with medicine, let alone respect for autonomy.
"Just as voluntary euthanasia leads ineluctably to non-voluntary, so we in Britain should be on guard against non-voluntary passive euthanasia which is quietly being justified in our own courts and hospitals and preparing the way for legislation which will permit more active killing - no doubt again deceptively described on the death certificate of the patient."
Gordon Macdonald, CEO of Care Not Killing, said, "With regulators and euthanasia campaigners closely intermingled, this case shines a spotlight on the weakness of safeguards and review procedures, as well as, frighteningly, on the whole culture around attitudes to end-of-life care in the Netherlands."