A Dutch cardinal said that a recent Supreme Court ruling permitting the euthanizing of dementia patients creates confusion and raises questions about consent, especially for the most vulnerable at the end of life.

Speaking on behalf of the Dutch bishops’ conference, Cardinal Willem Jacobus Eijk, the archbishop of Utrecht, high-lighted renewed concerns about the growing practice in the Netherlands in a statement provided to CNA April 23.

The cardinal referred to the supreme court decision, deliver-ed Wednesday, which found that doctors could forcibly euthanize dementia patients if they had previously signed a document approving the procedure.

“In 2016, a physician of a nursing home performed euthanasia in a woman who had a written euthanasia declaration, firmed four years before. This itself does raise the question of whether such a written declaration, firmed years ago, still expresses the actual will of the patient,” said the cardinal.

The woman, who was unable to communicate due to her condition, had stated four years earlier that she wished to decide when the time was right for her death. The woman resisted the attempt to place the needle in her arm, and was given a sedative in a cup of coffee. She was reportedly held down by family members, and was euthanized.