A Dutch doctor was acquitted on Wednesday in a landmark trial that prosecutors and physicians said they hope will help clarify how the country’s 2002 euthanasia law can be applied to people with severe dementia.

The doctor, who was not named in court, was cleared of any wrongdoing in carrying out euthanasia three years ago on a 74-year-old woman. The patient was given fatal doses of drugs despite some indications she might have changed her mind since declaring in writing she wanted euthanasia to be performed.

The court ruled in rare cases of euthanasia for patients with severe dementia – and who had earlier made a written request for euthanasia – the doctor “did not have to verify the current desire to die”.

Judges at The Hague District Court ruled the doctor met all criteria for carrying out euthanasia under the Dutch law legalising “mercy killing” by physicians. Applause broke out among the dozens of people who attended the hearing.

The doctor was accused of not acting with due care because, prosecutors alleged, she made insufficient efforts to find out whether the patient still wanted to die. To carry out the euthanasia, the physician drugged the patient’s coffee with a sedative before administering a fatal injection.

However, the patient woke during the procedure and had to be restrained by family members while the process was completed.

Mental competence

Prosecution spokeswoman Sanne van der Harg said prosecutors would carefully study the judgment before deciding whether to appeal.

Steven Pleiter of the Euthanasia Expertise Center welcomed the verdict.

“It feels good for people in the Netherlands that this is a clear view of the judges and court that it is possible to give euthanasia to a person who is not mentally competent any longer,” he said.

Under Dutch law, people are eligible for euthanasia if they make a considered, voluntary request for it and if their suffering is hopelessly “unbearable”. Patients can draw up a written request for euthanasia to be performed sometime in the future, in an advance directive, which should specify the conditions determining when they want to be euthanised.

Doctors must also seek the advice of at least one other independent physician before administering any fatal intervention.

Euthanasia cases among people with advanced dementia are extremely rare; there have been fewer than 20 cases since the procedure was legalised in 2002.

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“The most important issue we have to judge as doctors is whether there’s unbearable suffering for the patient,” said Dr Rene Heman, president of the Royal Dutch Medical Association.

He said the organisation was working on guidelines on how doctors should handle euthanasia cases for people with advanced dementia.

“As a doctor, you need to make sure people don’t change their minds,” he said.

Dutch investigators began scrutinising the case last September, marking the first time a doctor was criminally investigated for euthanasia.