In the Netherlands, euthanasia is legal if a patient’s physician is in compliance with all six criteria laid down in the Dutch Termination of Life on Request and Assisted Suicide Act, including a written advance directive. But in February and March 2017, about 460 Dutch physicians signed a petition stating they were not willing to perform euthanasia on severely demented patients who are no longer able to express their wish to die even if they have a written directive.
Dutch Minister of Health Edith Schippers said she will not adapt the current legislation, stating that the written advanced directive can take the place of an oral request at the time of the procedure. Minister Schippers argued that the strict guidelines for communication between a patient and his or her physician, among others requirements, guarantee a careful and transparent practice of euthanasia.
In the Netherlands, euthanasia in patients with dementia is extremely rare (five cases in 15 years). A physician may always refuse to meet a request for euthanasia from a patient, who may than seek help elsewhere.