Interior
The Health Inspectorate (IzG) and an inquiry soon present two reports on the case around GP Tromp from Tuitjenhorn, which was much in the news. What was that again? We talk to you in a few minutes.
The case
The publication of the reports of inquiry-Bleichrodt and the statement of facts by the Health Inspectorate (IzG) are the culmination of a case that has been playing for years. This began on August 19, 2013, when GP Nico Tromp went along with his co-assistant to a terminal patient in the village. The man had esophageal cancer and was discharged from the hospital to die at home. He was in bed and was very stuffy. His wife asked explicitly whether her husband could get something for anguish – it was a horrible sight.
Tromp squirted then, after getting the stuff in his practice, a gram of morphine in the leg of his patient. That is an unusually high dose that is lethal. Normally doctors serve in a situation of extreme distress at a terminal patient 10 to 50 milligrams of morphine increased. Tromp gave the man, in his other leg, also 350 milligrams dormicum. That is a sedative. The man died within half an hour. He had ever signed a living will, but later indicated would rather want to die by palliative sedation -. Pain so the patient dies in his sleep
Discussion
With this treatment on a summer day 2013 sets GP Tromp – still ignorant – one of the most complicated discussions within the medical profession under stress. How autonomous is the doctor, usually the doctor to choose between different forms of death of terminally ill patients. And how hard authorities may punish wrong choices?
The case Tuitjenhorn led to a huge public debate that just touches the core. After the death of the patient made Tromps’ trainee – intern at the AMC – reporting of this unnatural death. The Healthcare Inspectorate launched an investigation and switched Prosecutor. Inspection suspends Tromp. The GP is heard, gets depressed and commits three weeks after the death of his patient’s suicide. However, the widow of the patient that he killed satisfied with Tromps’ work; she is angry with the authorities, because they feel that Tromp wrongly identified as a suspect.
The fuss
This is primarily the reason great commotion among doctors. They are afraid that the police can just for the door as one of their terminal patients die. A few weeks after Tromps death the Healthcare Inspectorate publishes the “order” that gave Tromp. Only then that the doctor was administering too much morphine. The turmoil dies down somewhat. Doctors Federation Royal Dutch Medical Association and General Practitioners LHV, earlier still very critical, calling for independent research. That came just after two years out.
What types of die there?
This is different for each patient, but we assume the situation that GP Nico Tromp encountered in Tuitjenhorn. It is a terminal cancer patient who has indicated to death after he was put to sleep. There are three possibilities in the treatment of a terminal cancer patient who is very stuffy. These rules apply broadly to all patients who die are
Regular pain relief:. The doctor will give morphine to reduce distress. It is about 10 to 50 milligrams, possibly repeated over a longer period of time. Tromp gave 1 gram once – a lethal amount
Palliative sedation , or die dormant:. The physician should pain control agents to which the patient is asleep. The patient died a natural death, but this may take a few days. This may, if the doctor assesses a patient up to two weeks to live. An independent colleague does not need to be consulted
Euthanasia:. is the most extreme form, because the patient is made to death. This is done with muscle relaxants, which can be administered through a drink or an injection. To this is a lengthy procedure beforehand. The patient must be “hopeless and unbearable suffering” and with the right mind have made the choice to want to die.
This is fixed in a statement. The doctor should consult an independent colleague must agree. In retrospect, the ethics of euthanasia assesses whether all conditions are met. If not, then the doctor can be punished
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