LONDON — A court in the Netherlands on Wednesday acquitted a doctor who had been accused of unlawful euthanasia for administering a lethal injection to a patient with dementia, a case that raised questions about the clarity of the country’s law in such circumstances.
The patient, 74, who has not been publicly identified, had asked in writing for doctors to end her life if she had to be admitted to a nursing home, and if she thought the time was right. But, when she entered the home, incapacitated, she appeared to have changed her mind, giving “mixed signals,” about her intentions, prosecutors said.
A doctor at the home, now retired and also unidentified, decided to go through with the euthanasia, in close consultation with the family, in the spring of 2016.
A paper in the London-based Journal of Medical Ethics that reviewed the case said the doctor had put a sedative in the patient’s coffee and that the patient’s relatives had helped to hold her down as she struggled against the injection.
The review, published in 2018, said the case demonstrated the “myriad ethical concerns” raised by advance euthanasia directives.
Prosecutors said that the doctor did not act with due care, as required by the law. They said she should have cleared any doubt about the patient’s wish to die before going ahead with the procedure. Although prosecutors had pushed for a guilty verdict, they also made clear that they had brought the criminal case to try to resolve ambiguities of the euthanasia law, rather than to punish the doctor, whose motives they said were blameless.
The court cleared the doctor of any wrongdoing.
“The patient was heavily demented and deemed completely mentally incompetent,” the court said in an online statement. Medical records, heard during the proceedings, said the patient could not recognize her own reflection.
Taking into account the patient’s state, the court ruled that the doctor did not have to verify her wishes at the time of administering euthanasia.
Franz Zonneveld, a spokesman for the Public Prosecution Service of The Hague, said on Wednesday that the aim of the case had been to resolve the limits of the law.
“The court has given a clear ruling but on one point they have a very different view,” he said by phone, referring to the prosecutors’ belief that the doctor should have made greater efforts to confirm that the patient still wished to proceed with euthanasia.
“Even though she was suffering from dementia, you should check that as the physician, with the patient, and you should be 100 percent sure,” Mr. Zonneveld said.
Questions are often raised about the parameters for those wishing to end their lives and about who should be allowed to take that step, and lessons from the Dutch system often reverberate internationally. The debate can be particularly complex when dementia patients are involved, and opinion is often divided almost on a case-by-case basis.
In 2017, after reports of an increase in euthanasia among dementia patients in the Netherlands, and of a growth in the practice of administering sedatives before lethal injections, a group of more than 200 doctors signed a letter urging against euthanasia based on advance directives from patients. The doctors argued that they were reluctant to end the life of people who could not confirm that they still wanted to die.
Dr. Scott Y.H. Kim, a psychiatrist and bioethicist at the National Institutes of Health in the United States, wrote in an email that, “When a human being is resisting — regardless of how ‘meaningless’ the action is in terms of intentions and understanding — and what she is resisting is an act to end her life,” then it could be “pretty difficult to take in.”
Among other conditions, the decision to request euthanasia has to be voluntary and carefully considered, and the patient must be facing a future of unbearable suffering with no reasonable alternative. The physician has to consult at least one other independent professional, and the procedure to end the patient’s life should be administered in a medically appropriate way.
The court ruling on Wednesday underlined the legal position that a doctor can carry out euthanasia on patients at least 16 years old who have made written requests to die but are no longer able to express that will, as long as the due care criteria have been fulfilled.
The Dutch Public Prosecution Service said in a statement that the patient’s advance directive in this case was clear but that a conversation should have continued about the patient’s wishes.
“As long as that conversation gave cause for doubt,” the prosecution service said, “the nursing home doctor should have refrained from euthanasia.”
Princess Christina of the Netherlands, who married the Cuban-born administrator of a day care center in New York City and renounced her royal right of succession, died in Noordeinde Palace in The Hague on Friday. She was 72.
The government announced her death on behalf of the Royal House of the Netherlands in a statement that said she had bone cancer.
Christina was the youngest of four daughters to Queen Juliana, who died in 2004, and her German-born husband, Prince Bernhard.
As a royal, she shunned the spotlight, focusing on singing and collecting art with her husband, Jorge Guillermo, whom she married in 1975, raising a spate of publicity. Around the time they met, Christina had been living in New York and teaching music and French at a private school under the name Christina Van Oranje. Mr. Guillermo was described as an assistant director of a day care center in Harlem who had worked at Chase Manhattan Bank and was writing a book on opera. He had come to the United States in 1960 from Cuba with his father, a doctor, and his mother, a minister of higher education in the years before Fidel Castro took power.
Their wedding at the cathedral in Utrecht included some 1,100 guests, but it was relatively low-key and did not include the usual panoply of European royals.
The couple had three children, Bernardo, Nicolás and Juliana. They divorced in 1996.
With the marriage, Christina left the line of succession to the Dutch throne and lived outside the royal court, in Italy, the United States, including a number of years in New York, and Canada. Her sister, Queen Beatrix, abdicated in 2013. Queen Beatrix survives her, as do her other sisters, the princesses Margriet and Irene.
Mark Rutte, the Dutch prime minister, said that by relinquishing her right to the throne, Christina “created room for herself to lead her own life.”
It was, he said, “a life dominated by family, her great love of music and development of young singing talent.”
She was also interested in dance and sound therapy and worked with a foundation, “sharing her knowledge of techniques related to dance, sound and physical contact in support of the blind and visually impaired,” the statement said.
Christina was born on Feb. 18, 1947. At birth, she was partially blind and her mother sought help from a faith healer, Greet Hofmans, a decision that led to a royal crisis.
Ms. Hofmans reportedly exerted increasing influence over Queen Juliana to the annoyance of Prince Bernhard, leading to rumors of a possible divorce. The royal couple, however, remained married.
When I stood as an independent candidate in the Tower Hamlets’ mayoral elections of 2015, a white man asked me what colour my hair was under my veil. I said it was pink. He smiled, so then I added, “Not really, it’s green.” It was a small moment, but it got me thinking. I wrote an article – My Hair is Pink Under This Veil– and delivered a talk at Cambridge University.
Muslim women have endured all manner of law makers, politicians, and the public, giving them fashion tips. They think they’re trying to empower us. The former leader of the Commons, Jack Straw, claimed that community relations would be improved if they ditched the veil; former prime minister David Cameron commented that Muslim women were “traditionally submissive”.
Both white male politicians faced a backlash from the very Muslim women they thought they were liberating from enslavement.
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In October 2018, the UN criticised France for violating women’s rights, stating that rather than protecting women with the country’s ban on clothing that concealed faces, its consequence would be to confine them to their homes and marginalise them.
And just two days ago, the Partial Ban on Face-Covering Clothing Act, or burqa ban, came into force in the Netherlands. This law not only prohibits women from wearing face coverings such as burqas and niqabs on public transportation, in government buildings or at health and education institutions, but also outlaws anyone wearing full-face helmets, ski masks and balaclavas in the same places.
Muslim women wear a burqa as a symbol of their religious belief and religious freedom, in the same way that a Sikh would wear a turban. Veils (mantillas) are worn by some devout Catholic women in the UK and are a common sight in Spain and other Catholic countries in Europe.
Dutch police and transport companies have expressed a reluctance to enforce it. The police have stated that the ban is not a priority, so will not be able to respond within the usual half hour timeframe. The Dutch government now insists that the “partial ban doesn’t target any religion and that people are free to dress how they want”.
The reality of trying to impose a ban on what women wear proves that without the common will of the people, prejudicial laws such as the burqa ban are ineffectual. To restrict what people can wear based on their religious beliefs is a violation of human rights. Liberal western democracies cannot promote freedom of choice and expression on the one hand if they try and restrict what clothes people wear with the other.
The main question frequently asked about my veil (or hijab) is, “Is the veil really a choice, or is it a symbol of oppression?” People have every right to ask and as Muslim women we should respond in a way that helps others understand, not see questions as a challenge.
Let us not fool ourselves; without doubt, there are women who live in family units where they are forced to wear the veil. But there are people of all colours, cultures and religions who have husbands or wives who dictate what they should wear, what they should do and to whom they may speak.
Controlling relationships are not just a Muslim issue.
At primary school, a teacher decided to both impose the burden of representation on my young shoulders and question my Britishness when she informed my class that they should feel “privileged to have me as a classmate” because it would “widen their horizons”.
There are many powerful Muslim women in prominent positions who have overcome societal preconceptions to pursue their goals, which is testament to their fortitude. And there are tens of thousands of hijab-wearing Muslim women who will never have power but also challenge preconceptions when they walk out of their front door in the morning.
Muslim women are more than able to fight for their equality but need to be supported and celebrated to achieve that – just like women all over the world.
Enshrining common prejudice in law achieves nothing apart from exposing the lack of common sense of those who draft them.
Rabina Khan is a Bangladeshi-born writer and politician. She is a Liberal Democrat councillor for Shadwell in Tower Hamlets
But transportation and health officials said they would not prioritize the law, either.
Pedro Peters, the chairman of the Dutch Public Transport Association, told the Dutch news site NU.nl that just as the police would not see someone wearing a burqa or niqab as a top priority, transportation officials consider the movement of buses and trains to be their primary mission.
“You’re not going to shut down the bus for half an hour for someone who’s wearing a burqa,” he said. “We aren’t allowed to refuse anyone, because we have a transport obligation.”
Similarly, the Dutch Federation of University Medical Centers said that it would defer any enforcement to the police, according to The Associated Press. “We are not aware of any cases in which wearing face-covering clothing or a possible ban has led to problems,” its statement said.
In the confusion about who would enforce the law, the newspaper Algemeen Dagblad published an article this week suggesting that any Dutch person could make a citizen’s arrest. The police guidelines confirmed that a citizen’s arrest was possible, but urged people to be cautious.
“That was of course a very welcome signal to some of the right-wing politicians in this country who have sponsored this legislation,” said Tom Zwart, a professor of government at the University of Utrecht. “And for some people on social media, that’s an open invitation to start making life difficult for Muslim women.”
Of the Netherlands’ 17 million people, only about 150 to 400 women wear burqas and niqabs, according to Annelies Moors, a professor of sociology at the University of Amsterdam who studied the potential effect of the ban before it passed. She said that about 5 percent of the adult population was Muslim.
“The law provides a solution for a nonexistent problem, but may in turn cause problems,” she said.
The professor of government, Mr. Zwart, said that for women who wear burqas and niqabs, “it’s not symbolic at all, especially when a newspaper says citizens can make arrests,” he said. “Their safety is at stake.”
Just Eat told its noisy shareholders that a merger with Dutch rival Takeaway.com wasn’t on the menu when it updated the market in March. Now there’s a deal between the two at the door and steam is coming off the shares.
Reports of something in the offing started doing the rounds at the end of last week. This morning the terms were announced. That’s some smart delivering.
What’s being served up is an all share tie up in which the two sides, who said no no no when activist investor Cat Rock Capital started banging the table and demanding something be done just a few short months ago, theoretically sharing the spoils.
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So Just Eat gets to fill the positions of chairman and the finance director, while the shares will have a premium listing in London. But Takeaway.com’s youthful CEO Jitse Groen will run the business, which will be headquartered and domiciled in the Netherlands under the Dutch corporate structure.
His colleagues are slated to hold two of the other three top executive positions.
Takeaway.com, a significantly smaller business in terms of number of orders, earnings and revenues, is clearly the winner. It’s eating its rival. This is a takeover in everything but name.
Just Eat’s investors could scarcely be happier about that. The shares shot up by 25 per cent. Compare that to Takeawawy.com, which put something more like 3.5 per cent despite apparently getting the better of the deal.
Part of the discrepancy can be explained by speculation that a counter bid may emerge for Just Eat, and it’s a realistic possibility. Partly it’s because Groen is well regarded and the deal gets Just Eat out of a real hole.
It was much criticised for under delivering under former boss Peter Plumb. When his acting replacement Peter Duffy made it clear he didn’t want the job on the permanent basis, it wasn’t altogether clear where the company would turn (other than to Groen).
When you’re in a sector that is evolving as rapidly as this one is, uncertainty at the top is lethal. When you have companies like Amazon (an investor in Deliveroo) and Uber moving into your territory, that’s doubly the case.
You could almost consider a combination of the two as a European champion to take on the American tech giants were the British government not so intent on tearing Europe apart. If you really want a laugh, the shares in the combined company are split 52 to 48 (Just East gets the bigger number).
Cat Rock’s purring meanwhile. That was the obvious line doing the rounds. In reality, however, it’s pushed the two companies down a road they almost had to follow. Now it’s on Groen to prove he’s as good as the hype says he is, otherwise he’ll be the next dish on the menu.