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Table 1 The requirements of due care in Dutch law as stipulated in the Article 2 of The Termination of Life on Request and Assisted Suicide Act

From: Euthanasia in advanced dementia; the view of the general practitioners in the Netherlands on a vignette case along the juridical and ethical dispute

Under the law, the definition of euthanasia applies when a physician ends the life of a patient at his express request due to unbearable and lasting suffering. Euthanasia means that the physician administers a lethal substance to the patient. In the case of assisted suicide, the physician supplies a lethal substance that the patient takes in the physician’s presence.
The physician must:
a. Be satisfied that the patient’s request is voluntary
and well considered.
b. Be satisfied that the patient’s suffering is unbearable,
with no prospect of improvement.
c. Have informed the patient about his situation
and his prognosis.
d. Have come to the conclusion, together with the
patient, that there is no reasonable alternative in
the patient’s situation.
e. Have consulted at least one other, independent
physician, who must see the patient and give a
written opinion on whether the due care criteria
set out in (a) to (d) have been fulfilled.
f. Have exercised due medical care and attention
in terminating the patient’s life or assisting in
his suicide.
The Act stipulates in section 2.2 that a patient
aged 16 or over who is decisional competent may
draw up an advance directive, setting out a request
for euthanasia. If at some point the patient is no
longer capable of expressing his will, the physician
may accept the advance directive as a request
pursuant to section 2 (1)(a) of the Act.1 2 The
advance directive thus has the same status as an oral
request for euthanasia