The Dutch medical profession has rejected the opinion of justice minister Piet Hein Donner that the man suspected of murdering former politician Pim Fortuyn could be force fed to allow the judicial process to proceed.
The Royal Dutch Medical Association has argued that medical ethics has never allowed doctors to force treatment on a competent patient.
The suspect, Volkert van der Graaf, who has been on hunger strike since 12 July, has been judged competent by two independent forensic psychiatrists. He has been taking only fruit juice and sugared tea and coffee, in protest at constant camera surveillance of his cell.
In answer to MPs' questions Mr Donner has claimed that there are legal grounds for prisoners to be obliged to tolerate medical treatment, including feeding. He says that a decision to treat a prisoner could be taken by an institution's director if a doctor judged treatment was necessary “to avert serious danger to the health and safety of the prisoner or others.” Carrying out that decision remained with the doctor.
Mr Donner added that there were more considerations than just the wishes of the person concerned. “I attach great importance to an undisturbed judicial process.”
All three political parties from the governing coalition accept the principle of force feeding, arguing that the right to self determination is not sacred and should be weighed against the overall social unrest caused by the case.
The medical human rights group the Johannes Wier Foundation has called on the Royal Dutch Medical Association to clarify its position. The association has now strongly advised members not to cooperate with the force feeding of a competent prisoner.
Key to its position are two issues: the patient's right to self determination and the doctor's professional autonomy. These should enable a patient to have trust in his or her doctor in all circumstances, it says.
The association quotes the World Medical Association's declarations of Tokyo (1975) and Malta (1991) forbidding force feeding of competent patients and arguing that decisions must be left to doctors “without the intervention of third parties whose primary interest is not the patient's welfare.”
The association sees no reason to deviate from these declarations, arguing: “Social and political pressure are not criteria for doctors.”
Figure.
THEO KOCK/AP PHOTO
Volkert van der Graaf, who has been on hunger strike since July