Two recent test cases in the Netherlands have helped to clarify the distinction between murder and palliative care. In the first, the Dutch Supreme Court rejected an appeal by an Amsterdam GP, Dr Wilfred van Oijen against a charge of murder. He had an 84- year-old patient in a coma who was expected to die within 48 hours. He injected 50 mg of alcuronium and soon afterwards she died. Dr van Oijen's defence was that this "help with dying" was palliative care. However, the Supreme Court rejected this argument. Because the patient was in coma, she was not suffering, and because she had not requested euthanasia, his "life-ending treatment" was murder. He was sentenced to one week in prison suspended for two years.
In the other case, a junior hospital doctor was acquitted after he increased the dose of morphine administered to a dying patient with breathing difficulties. As the patient's condition worsened, the doctor gave him midazolam and shortly thereafter he died. The doctor was arrested. The Supreme Court found that the drugs he used could shorten a patient's life, but in this case the doctor did not intend to do so.
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