Breach of the guidelines
In how many cases of VAE was there a 'free and voluntary' request which was 'well-considered, durable and persistent'? In how many was there 'intolerable' suffering for which VAE was a 'last resort'? In how many did the doctor consult with another doctor and subsequently report to the authorities?1 The Survey contained telling evidence also about the extent to which Dutch doctors did, and did not, comply with the guidelines. This chapter will summarise that evidence, which betrays widespread noncompliance with the guidelines, not least the practice of NVAE.
durable and persistent'?
Doctors stated that in the 2,700 cases of VAE and PAS there was an 'explicit request'2 in 96%; which was 'wholly made by the patient'3 in 99% of cases and 'repeated'4 in 94%; and that in 100% of cases the patient had a 'good insight'5 into his disease and its prognosis. Oddly, no specific question was put about the voluntariness of the request and there is no evidence of any mechanism which could have guaranteed that the request was voluntary. Moreover, the request was purely oral in 60% of cases6 and, when made to a GP in cases where a nurse was caring for the patient, the GP more often____________________