荷兰安乐死实践中最具争议的问题是,根据预先指示中提出的要求,在痴呆症晚期患者的情况下实施安乐死。当这样的病人,尽管缺乏对此事的决策能力,显示了一个希望生活的迹象。在2020年4月21日的两项重要判决中,荷兰最高法院裁定,已提出的请求不能被无效撤销。在这篇评论中,我考虑了荷兰专业组织最近发布的两份与这些决定相反的文件,特别是一个指导方针,指出在正确理解决策能力的基础上,表达一个精神错乱的人的生活愿望,然而口齿不清,应该始终被认为是胜任的。
The most controversial issue in the Dutch euthanasia practice concerns the performance of euthanasia in a case of a patient in an advanced state of dementia on the basis of a request that is laid down in an advance directive. This is particularly controversial when such a patient, although lacking decisional capacity on the matter, shows signs of a wish to live. In two important verdicts of April 21 2020 the Dutch Supreme Court has ruled that a request that has been made competently cannot be revoked incompetently. In this comment I consider two recent documents from Dutch professional organisations that are contrary to these decisions, in particular a guideline stating that on a proper understanding of decisional capacity the expression of a wish to live of a demented person, however inarticulate, should always be considered to be made competently.