The Dutch way of voluntary death
This is a long and very chilling report on how legalized euthanasia operates in the Netherlands. I’ve read about the phenomenon before, but not in as much depth.
The suffering that can occur, particularly at the end of life, can be extremely profound. People want relief, relatives want help, and doctors are placed in the middle of it. Although they’ve taken an oath to help people and hope to save as many from illness and pain as possible, with doctor-assisted suicide doctors are called on to administer death.
Some will not do it, but according to the article, in the Netherlands only 8% of doctors say no. I find that a remarkably small number. We’re not talking about the administration of doses of morphine as life is ebbing and suffering increasing. We’re talking about something else entirely, something much more dramatic and more clearly willful killing, and the Dutch experience is that the slippery slope is very real:
“The process of bringing in euthanasia legislation began with a desire to deal with the most heartbreaking cases – really terrible forms of death,” Boer [an ethics professor] said. “But there have been important changes in the way the law is applied. We have put in motion something that we have now discovered has more consequences than we ever imagined.”
I think they lacked imagination—the basic consequences were quite obvious from the start, and those who didn’t see them were deluded. The article discusses some very harrowing “assisted” deaths that have occurred at the hands of doctors. This one in particular seems to have been horrific, so much so that the doctor is being charged with malpractice:
It involves a dementia sufferer who had asked to be killed when the “time” was “right”, but when her doctor judged this to be the case, she resisted. The patient had to be drugged and restrained by her family before she finally submitted to the doctor’s fatal injection. The doctor who administered the dose – who has not been identified – has defended her actions by saying that she was fulfilling her patient’s request and that, since the patient was incompetent, her protests before her death were irrelevant. Whatever the legal merits of her argument, it hardly changes what must have been a scene of unutterable grimness.
The underlying problem with the advance directives is that they imply the subordination of an irrational human being to their rational former self, essentially splitting a single person into two mutually opposed ones. Many doctors, having watched patients adapt to circumstances they had once expected to find intolerable, doubt whether anyone can accurately predict what they will want after their condition worsens.
Much more at the link.
One of the interesting things about the article is that it discusses an aspect of euthanasia that I’ve long thought was almost ignored: its effect on family members who may not agree with the decision (particularly in non-terminal cases) but cannot stop it, or even family members who agree with it but who are present at the death and traumatized. There are many dangers, in particular that a person who is primarily depressed uses a physical ailment to obtain the suicide he or she would want even without that illness.
Suicide, assisted or otherwise, nearly always hurts the surviving family members very intensely. But knowing that the doctors and the state are helping out must add an extra burden for some of these families. Of course, watching a family member suffer through a natural death (even with the help of morphine, something I’ve witnessed several times) is terrible as well.
[NOTE: Religion doesn’t seem to be much of a factor in the Netherlands.]
[ADDENDUM: Here’s a beautiful and relevant essay by Gerard Vanderleun of American Digest.]
Planned Patient for the people, persons that are no longer viable. PP is a human rights-approved institution, with a record of nearly 100% abortion rate, and politically tolerable collateral damage. It’s a wicked solution, to an albeit hard problem.
I’m reminded of the 19th-and-before century policy of a husband’s being legally permitted to institutionalize his wife if she started to exhibit “hysterical” behavior (like resisting sex or disagreeing with her husband). I gather that this also might require a doctor’s signoff, which was easy to get if the woman had no allies, and possible even if she did have allies.
Doctors MUST be aware that what could strike a 50-year-old as an untenable quality of life might not be so untenable at 70. In my own experience, my goodness, if I’d awakened one morning at 26 with the aches and pains I have at 52, I probably would have thought “How can this life be worth living?!” But ramping up to it over the ensuing 26 years makes my 52-year-old mornings perfectly acceptable.
It seems to me that the only possible way to implement an assisted-suicide policy ethically, if that’s the direction we’re going, is to say that the patient’s CURRENT state of mind is the ONLY important factor if the person is able to communicate at all, no matter whether they are thought to be “rational.” If the patient is not able to communicate, then ANY person related or associated with the patient who advocates for the patient’s continued life should carry the day. This is the precautionary principle, yes – but the possibility of abuse is so terribly easy to see in such a policy that I’m willing to go with the precautionary principle.
It just makes me shudder. The Netherlands – it seems like such a nice place until you scratch it with a fingernail to see what’s under the paint.
Considering it’s the Guardian that article was pretty balanced. Even referred to it as ‘killing’ someone at one point.
The story of the obese mentally ill 30 something year old man was deeply troubling. I know these things can be difficult but for me if you can physically live many, many more years I’ve got a problem with that.
And what of the person with no family (which will be more common going forward)? How long til some doctor or board makes the call.
They could call it a ‘death panel’…
I occasionally practiced passive euthanasia when I was caring for patients. It was always with consent and I never gave anyone a lethal drug or narcotic overdose but my professor, in the old days, would treat patents with end stage metastatic cancer with high dose steroids, which induce a sort of euphoric psychosis. Then, when they could no longer function at home, he would admit them to the hospital and “forget” to order the steroids. They would quickly expire of adrenal insufficiency. Once the lawyers got involved, of course, that was all over.
I have several stories in my book.
In the 1980s, shortly before I retired, the Wall Street Journal had a front page article about euthanasia in the Netherlands. They said no doctor would kill a patient at the time but any doctor who admitted an emphysema patient to ICU would lose his/her job. They got a lethal dose of morphine in the ER.
I am reminded of another form of death-dealing that was sold to the public as being “safe, legal, and rare” — which turned out to hit only 1 of the 3.
Another interesting analog with the above-mentioned procedure:
“After the Levenseindekliniek was founded in 2012, Pleiter sat down with the insurance companies to work out what they would pay the clinic for each euthanasia procedure its doctors perform. The current figure is €3,000, payable to the clinic even if the applicant pulls out at the last minute. I suggested to Pleiter that the insurance companies must prefer to pay a one-off fee for euthanising someone to spending a vast sum in order to keep that person, needy and unproductive, alive in a nursing home.
Pleiter’s pained expression suggested that I had introduced a note of cynicism into a discussion that should be conducted on a more elevated plane.”
Having read Vanderleun’s essay; you are correct, Neo, both beautiful and relevant. On a tangential note, though, it is my understanding that Gerard Vanderleun was one of the people who lost his home in the recent California Camp Fire. Does anyone know if any kind of support page has been established for him?
The American way of voluntary death.
https://www.nationalreview.com/corner/attempt-to-expand-oregon-assisted-suicide-license/
“Oregon’s assisted-suicide legalization was the tip of the spear. Its provisions were never intended to remain restricted in perpetuity, but rather, were designed to give people false assurance that the ambitions of the euthanasia movement are limited.
They aren’t.
…
There is an even more radical assisted-suicide legalization bill pending in New Mexico, which I described here. Delaware assisted-suicide enthusiasts will follow up a radical bill from last session with another, that I will detail once it has been officially filed.
1
Why do I keep bringing these proposals up? I want people to understand that the glib promises of tight restrictions made by U.S. activists are tactical lies designed to convince the reluctant to accept legalization. They are not intended to be permanent features of assisted-suicide practice going forward.
Those with eyes to see, let them see.”
T on January 19, 2019 at 4:36 pm at 4:36 pm said:
Having read Vanderleun’s essay; you are correct, Neo, both beautiful and relevant. On a tangential note, though, it is my understanding that Gerard Vanderleun was one of the people who lost his home in the recent California Camp Fire. Does anyone know if any kind of support page has been established for him?
* * *
Check the side-bar at the link, or click on the top graphic to go to Home.
His blog is well-attended, and many have contributed to help him recover.
All Gerard’s essays are worth reading.
And, he writes poetry the way it should be written.
Hollanders have become pagans. They are on their way to becoming Aztecs, cutting into the chests of non-anesthetized patients and ripping out their hearts in sacrifice to their secular god.
Shall we be led down that same road by our ‘betters’, those who know what is best for us and will see to it that we get it whether we want it or not.
The stage curtain drawn open in the West by the Enlightenment is being drawn closed again. The play will soon be over.
Aesop Fan,
Thanks
No one who was paying attention should be surprised at what’s happening in the Netherlands. And, like much of western Europe, the old faith is fading fast. The horrors of the new ones (secularism and Islam) are beginning to be visible.
The “assisted” part of suicide is a bit of a red herring. In many cases, the only reason that someone needs assistance is because the law denies him a simple, painless way of dying that he could do himself if permitted. I understand these are not all the cases. But I think these are the cases that should be discussed first. Denying this permission is a strong form of anti-euthanasia.
I think it is a basic human right to have the right to die — simply, painlessly. I also admit that there would be negative consequences for society if people had this right. For example, old, sick people might feel obligated to do it. On the other hand, all sorts of rights have the negative consequence that people feel pressure to invoke them. Nonetheless, this is a right I think we should have.
Denying this permission is a strong form of anti-euthanasia.
The combination of the lawyers plus “ethics committees” have made euthanasia a court case. Fifty years ago, doctors and families made these decisions. Of course, doctors are now captives of the beast and can do nothing that they are not told to do. I am so happy that I am long retired. Surgery was fun and I still dream of doing it but the whole profession is trapped in a nightmare.
The Dutch cases remind me of what even Wikipedia calls the “regicide” of King George V (the Queen’s grandfather). Lord Dawson of Penn, the king’s personal physician, noted in his diary that he deliberately injected his patient with morphine on the night of January 20, 1936, when the king was slowly dying of bronchitis. Dawson maintained “that he acted to preserve the King’s dignity, to prevent further strain on the family, and so that the King’s death at 11:55 p.m. could be announced in the morning edition of The Times newspaper rather than ‘less appropriate … evening journals.’ ” Neither the king nor any member of the family had asked Dawson to speed his death, nor did Dawson consult either Queen Mary or the Prince of Wales [later the Duke of Windsor]. He acted on his own. Dawson supported what he termed “the gentle growth of euthanasia” but he opposed its legalization by Parliament on the grounds that it is the proper business of the medical profession and not of lawyers.
Dawson’s act became public knowledge when his diary was published in 1986. The British Medical Journal condemned the king’s euthanasia as an “arrogant convenience killing.” One reader wrote a brief four-line poem on the subject:
Lord Dawson of Penn
Has killed many men.
That’s why we sing
“God Save the King.”
I don’t know if I had gone into the Guardian article specifically looking for what I felt would be a keystone, i.e. a central concept or kernel, but I think I may have discovered in it one that explains much about why the euthanasia movement is making progress in NL and elsewhere. It’s the next part of the quotation that Aesop provided above: “[Pleiter] restated the credo that animates right-to-die movements everywhere: ‘I strongly believe there is no need for suffering.’”
Do I, then, as a Christian believe that there is in fact a “need” for suffering? I would say on some level, a spiritual level: yes. The idea of redemptive suffering among the pains of daily life is an idea that I first encountered in a conversation with a local Orthodox priest that I know here and has come to make more sense to me as time goes on. The paramount New Testament quote for me on this point is this, addressed to the Christian community in general (the initial “we”):
“… we rejoice in our sufferings, knowing that suffering produces endurance, and endurance produces character, and character produces hope, and hope does not disappoint us, because God’s love has been poured into our hearts through the Holy Spirit which has been given to us.”
There is also this rather interesting thought at the end of the Guardian essay: “The question for any country contemplating euthanasia legislation is whether the practice must inevitably expand – in which case, as Agnes van der Heide recognises, death will eventually ‘get a different meaning, be appreciated differently’.” That is a consequence to which I’ve not yet given much thought and I’m not sure I understand yet what it could be. But I think that even without this quotation, there are correct and incorrect views of death; and it makes sense to me that in this brave new world, the common society-wide view of death and its significance could shift into something that I would regard as largely incorrect. Of course, this is on a time scale of decades to generations, and given the fact that my own views have over that same time scale shifted in the opposing direction, it’s kind of like watching planets in orbit, or icebergs.
One notes that while the pre-dementia patient may be more competent in many matters, in one matter, the dementia patient is one respect is certainly superior: in knowledge of what living with dementia is like. So the consent was made in ignorance, and the resistance with full knowledge.
Two notes I found telling — first, “At any meeting organised by the NVVE, you will look in vain for poor people, pious Christians or members of the Netherlands’ sizeable Muslim minority. Borne along by the ultra-rational spirit of Dutch libertarianism (the spirit that made the Netherlands a pioneer in reforming laws on drugs, sex and pornography), the Dutch euthanasia scene also exudes a strong whiff of upper-middle class entitlement.”.
Second, the statistic about the necessity of Mommy — 95% won’t do it themselves but want the doctor to do it, which the author relates to assent of “authority.” In cases of guilt over our actions, we’ll substitute the approval of society to God’s.
Since my last surgery in March, 2017, I have thought quite a lot about the agony of being near death, but with maybe several months,, or even years, before you are released from your suffering.
In the first three days after surgery my recovery was normal, but then I contracted c-Dif. Things went downhill rapidly. My heart rate was a steady 135 and because I had a tube down my throat to evacuate bile, they could not give me the medicine for the c-Dif. They had to move me to cardiology to get me infused with a medication to slow my heart rate. That took two days. I began to fear I was going to die. I was having a bowel movement every three hours and was too weak to even roll over while nurses changed me. It took two more days before they decided I needed to be fed intravenously. By this time I was so weak and out of it that I began to hope that I would die. I was helpless, unable to do anything but lie there and sh*t. After two days of intravenous feeding and with my heart rate down to 70, I began to rally. I was now able to roll over to have the diaper changed. I was then wondering if I might recover. Over the next fifteen days, I finally got the tube out of my stomach and began the c-Dif medication, The intravenous feeding was working. I was able to sit up, then to walk a bit around my bed. The medication was working. I quit having loose movements. It took all my strength to force myself to begin walking down the hall and back. I began to hope I would recover. They took me off the intravenous feeding and started me on a soft diet. Then I went home where my wife ministered to my needs and I walked further every day, celebrating being able to go a bit further every day
Here it is almost two years later and I am still in recovery mode I’m glad I made it and happy for the extra life granted me, but I remember when I wanted to die because I was so weak, helpless, and without hope. I fear being in that situation again. I now know how difficult it is for someone who is in pain, incontinent, weak, helpless, and with only a shred of hope to want to go on living.
I’m 85 and have had a wonderful life. I don’t fear death, I know it’s coming. But I now fear a lingering death filled with helplessness. I will never accept another major surgery. Another major illness with a fatal prognosis, I would prefer to be kept comfortable and let nature take its course. But I can understand why some people might choose voluntary euthanasia.
The essay by Gerard Vanderleun is well worth the time to read. I heartily encourage it.
Vanderleun’s essay is seductive and fanciful.
He lacks insight into the struggle with dementia, the process and progress of dementia. All the demented have a “Palace of Memory” because recent memory evaporates while remote memories are preserved. One does not ‘create’ that ‘Palace’; it just happens. His is an egoistic statement.
He also does not seem to understand C.S. Lewis’ meaning, though he quotes him.
The quote: “C. S. Lewis observed ‘You don’t have a soul. You are a Soul. You have a body.’ ”
Then Vanderleun writes: “Live long enough and your body slowly betrays you and sometimes takes your mind and soul with it.” He doesn’t get it.
Who and what is the “you” that is betrayed by its body, and takes its soul with it down the betrayal road? The body does not betray, any more than a vehicle in stall mode betrays its owner. V. mouths the ‘soul’ word but does indicate any comprehension of the nature of Soul.
Lewis was a devout Christian. Vanderleun, not so much, apparently.
I will never accept another major surgery.
I did a research study about 20 years ago showing that the elderly over 80 are NOT the cause of high healthcare costs. The peak spending on Medicare is about age 70. After 80, it goes way down.
I should add that I have done major surgery on elderly up to age 103. There just has to be a good reason.
I am currently reading about the development of euthanasia in the book The Negro Project by Bruce Fleury. It’s more examining Margaret Sanger and eugenics but euthanasia is a large part of that.
There are odd and ill-considered comments drawn out by this piece of Neo’s.
Take LTEC’s ” I think it is a basic human right to have the right to die — simply, painlessly.”
What is a basic human ‘right’? Is it a right to life? Is it a right to live a long, non-suffering life full of joy?
Many who promote euthanasia (“the right to die”) on the left also use “suicide by gun” in statistics of gun violence in an attempt to deny us the right to self-defense.
Duplicitous.
THE basic human right is the right of self-determination.
It is because everyone has this right that the right itself requires that no one interfere with others in a way that expropriates their own rights of self-determination.
Your right of self-determination includes your right to live or die as you see fit, provided that you don’t force or deceive others into helping you do either.
The problem is that not everyone is mentally capable of “knowing” how to use his right of self-determination; and by “mentally capable,” I mean that the condition of their physical brains prevents full capability, in that the basic structure may be less than fully developed (but what does that mean exactly?), or damaged, or just plain lacking in some important components.
One example is the children, whose brains aren’t yet fully developed structurally, let alone with the enhanced functioning that experience and intellectual knowledge bring. Another is those who have senile dementia or Alzheimer’s. Another is those who are amnesiac, or in coma. And another is those who are fine as far their own capacity for self-determination is unimpaired, but who cannot or who refuse to honor the like right of others. (Anybody who willfully commits murder, and especially the “homicidal maniacs” like Richard Speck or J. Dahmer, or the Islamic terrorist zealots.)
So all of us in society who are not in any of those positions have to decide whether, and if so how, to safeguard those who are. And the job is to honor their own rights of self-determination insofar as is possible.
The Great Frog and I are open to any suggestions.
.
P.S. I have no experience whatsoever with Alzheimer’s, but what I’ve read and what I know of my Grandmother’s case (I never saw her at all after its onset) leaves me wondering whether its victims, at least in the later stages, “know” their inner condition in any meaningful sense. Yes, I’m sure they are aware of themselves and their inner world, but I wonder if they have any capacity to judge it as something they want to continue or something they would rather be done with. I suppose some of them, at least, have the pre-intellectual urge to live, like most mammals … but can they intellectualize about their state enough to form judgments? I just don’t know.
A couple of years ago I had to spend two months in a nursing home, and one of my table-mates seemed pretty non-compos. I’m told she had Parkinson’s, but I don’t know if that’s true or not. But here’s the thing. Her husband came to eat supper with us every night, and helped her with her eating (she had little appetite and also had some trouble keeping things down). But most Sundays he would come and wheel her outside, if the weather was good, and her happiness at seeing him on those occasions was a joy to behold.
I hope that her happiness on those days made whatever went on in her head and her body the rest of the time worth it.
. . .
Ed: Yes, excellent point.
My best friend suffers from Alzheimer’s. His wife cares for him at home.
He does not recognize me (or anyone).
There is someone in there who can’t maintain a coherent thought.
I saw that early on.
He’d start to talk to me and it made sense and I felt elation.
Then, that train of thought ran out of track and came to a halt before reaching it’s destination.
He’s in there.
He just lost the ability to come out.
Ed … I’m very sorry.
Dear Cicero,
One upon a time in the study of the wilderness I used to collect and dissect owl pellets to see the detritus inside them. You’ve made me remember those times, kiddo.
And by the way, I knew Cicero and you, kiddo, are no Cicero.
Julie near Chicago earlier wrote in part, “Your right of self-determination includes your right to live or die as you see fit, provided that you don’t force or deceive others into helping you do either.”
Does not seem as though she has thought this through.
If there is an absolute right of self-determination, as she avers, then what is morally wrong with deceiving others into helping you die or, she adds oddly enough, to live? Would deceiving a kidnapper who intends murder of the kidnapped be a wrong, in order for the victim to survive, escape, and live?
Does she claim that deception is a mortal sin? Or that this non-forcing, persuasive tool, deceit, is a great evil, greater than the suicide which deceit may aid in achieving?
Isn’t this whole euthanasia thing the fetish of upper middle class, middle aged, non-religious whites? Not the need for it in awful cases but the whole public discourse on it?
These people aren’t having children, are frequently alienated from their own families, have seen their relationships dominated by breakups and divorce, and can no longer pretend they’re going to be rich and famous one day. The prospect of euthanasia is to them what opioids are to their working class counterparts. But as usual, the working class only hurt themselves while their alleged betters screw it up for everybody.
I mean, we’ve got millions and millions of old and aging Baby Boomers staring down that lonely road but they don’t seem to be embracing death as a way out.
Mike
Their is the whole Imago Dei thing.
Even if you kill yourself, you are striking at God.
As a young catholic boy, I was taught that suicide was the result of despair, the opposite of faith. The protestants taught me “The just shall live by faith”.
Just imagine assisting someone in their death to have someone else burst into the room with a cure.
The reality of “assisted suicide” is that it frequently results in children pressuring their parents to do it because they’re tired of caring for them or they want their money or both.
“Just imagine assisting someone in their death to have someone else burst into the room with a cure.”
Didn’t we see that in “Romeo and Juliet”?
Cicero: The point is that everyone has the right of self-determination, BUT only as long as they don’t try to take over another person.
And “taking over another person” means getting him to act according to YOUR will and not HIS. That means, precisely, that you are co-opting his right to act according to his own will: that is, freely, with the issue of force not even on the table.
Deception is, again, a way of getting the other guy to do things your way, by telling him lies that cause him to use his will according to your wishes. You give him false information that causes him to misjudge how the actions you want fit in with his own outlook, or aims, or objectives, or moral beliefs (which are a part of his own outlook).
But in neither case does our guy have the right to act according to his own free choices, if doing so would involve his co-opting yet a third party’s right of self-determination, except in self-defence or the defence of innocent others.
That is the basic position, and it is derived by consideration of our own human nature and the nature of the rest of reality. It is a First Principle of moral philosophy, and it is the only First Principle that allows human beings to live together as free men and slaves, or part-time slaves.
Slaves are those who have no RIGHT to choose their own actions, or to get their own information, or to draw their own conclusions, or to eat or sleep or keep warm or even to breathe.
We do not exist in order to be somebody’s, anybody’s, slave. And no one is in the right to assume control of us in any fundamental sense.
We lose that right only when we propose to rob somebody else of his.
We may rightfully strike a bargain by which we will do someone else’s bidding for a specific and limited period of time, and within very narrow limits, when the other person will do something we judge to be good for us. This is the bargain between employer and employee, and slavery, real, non-metaphorical slavery is no part of it.
.
That is the basic position. In the real world, we let others encroach on our rights to self and property to, one hopes, a minimal extent, because we know there are situations where cooperation is a better strategy for living on our own terms than a strict “my way or the highway” would be. But deciding what encroachments we will permit is a fraught business.
.
Not everyone accepts this as the basis of his moral philosophy, of course. And everyone is welcome to his own views, according to this philosophy, as long as he doesn’t propose to force other people to act in accordance with them or to hurt them in one way or another if they don’t.
This is another area in which my moral viewpoint conflicts with “Conservative” thought. I believe that individuals of sound mind have every right to determine the time of their own death if that is their wish.
Dying is the very last thing we will ever do. I can respect the desire of many to leave this “mortal coil” with dignity, instead of a slow and agonizing death. I do not know for certain what I will choose, but I like the idea that I have options and that I can decide. Those who do not know me and would deny me those options are meddling in matters that do not concern them.
I believe that individuals of sound mind have every right to determine the time of their own death if that is their wish.
Your contention was anticipated by Dame Cicely Saunders forty years ago: decisions are made in a social context. “Knowing human nature, euthanasia won’t be voluntary for very long”. The Dutch have been proving her right. It’s time for the police and the courts in the Netherlands and Belgium to suppress the practice. And that means doctors in prison for long sentences.
“Knowing human nature, euthanasia won’t be voluntary for very long”. The Dutch have been proving her right. It’s time for the police and the courts in the Netherlands and Belgium to suppress the practice. And that means doctors in prison for long sentences.
Won’t happen. Doctors have no freedom and we are on our way there. If a doctor admits an emphysema patient to ICU, he/she is fired. The Dutch lie about it although they seem to be getting more brazen about it.