Dutch authorities are prosecuting a doctor for euthanising an elderly woman with dementia in the first case of its kind since the practice was legalised in 2002, officials said Friday.

The female doctor, who was not named, allegedly put a sleeping drug into the 74-year-old woman’s coffee and had to ask her family to hold her down when she began to struggle.

The Netherlands and neighbouring Belgium became the first countries in the world to legalise so-called mercy killing, but it can only be carried out by doctors and under very strict conditions.

Prosecutors said the doctor in the case “overstepped the mark” with the nursing home patient, who had written a will saying she wanted to die but did not clearly say so at the time of her death.

“A nursing home doctor who performed euthanasia in April 2016 on a 74-year-old demented and incapacitated woman will be prosecuted,” the Netherlands prosecution service said in a statement.

“This is the first time that the Dutch Public Prosecution Service will prosecute a doctor for euthanasia since the introduction of the Act on Termination of Life on Request and Assisted Suicide in 2002.”

The doctor believed she had acted cautiously and “welcomes further guidance on the question of the wishes of incapacitated patients,” her spokesman was quoted as saying by the NOS public television channel.

“She regrets however that she has been prosecuted for this.”

Coffee sedative

A regional euthanasia review board had said in a 2016 report that the doctor had put the sedative dormicum into the woman’s coffee to ensure she was peaceful while the fatal drug was administered a few minutes later.

But it found that the elderly woman stood up while the euthanasia drug was being injected, adding that “the patient’s family then helped to restrain the patient and the doctor quickly administered the rest”.

Prosecutors said Friday that the woman’s will, drawn up several years before her admission to the nursing home, was “unclear and contradictory.”

“Although the woman had regularly stated that she wanted to die, on other occasions she had said that she did not want to die,” it added.

“The doctor should have checked with the woman whether she still had a death wish by discussing this with her.”

Prosecutors added that the case “addresses important legal issues regarding the termination of life of dementia patients. To get these questions answered, the prosecution service now presents this specific issue to the court.”

In 2017, some 6,585 people chose euthanasia to end their own lives in the Netherlands, about 4.4 percent of the total number of more than 150,000 registered deaths in the country, according to the Regional Euthanasia Review Committee which strictly monitors all cases.

Twelve cases were identified as having possible concerns by the committee, of which two are now under investigation by prosecutors.