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The case of Noa Pothoven — 51 Comments

  1. The story of Noa Pothoven is truly sad. She was destroyed by her attackers. Not many of us can escape the mental anguish that she underwent as a result. There are also thousands of girls who were “groomed” in England with no recourse to the authorities (who turned a blind eye to the crimes). They will also carry the trauma to their graves.

    I suggest those who follow Noa’s story also follow that of Aurora Mardiganian. Aurora underwent even greater trauma, and survived. She also worked to expose her attackers and lived for more than 90 years.

    Her story was published long ago, and is available for free in multiple formats at:

    https://www.gutenberg.org/ebooks/53046

    Her wikipedia entry clarifies why one particular horrific episode she narrated was softened for the American audience, who would not have been able to stomach what really happened.

    https://en.wikipedia.org/wiki/Aurora_Mardiganian

    Her story is one that must never be forgotten.

  2. Thank you for not immediately jumping on this story, and digging deeper to get better information. Still heartbreaking, but for very different reasons.

    Sadly, it’s also yet another example of why it pays to wait for the second version of a story.

  3. She was sexually attacked three times in three years by three different sets of perpetrators? Has anyone attempted to verify that?

  4. she made a series of attempts to kill herself in recent months.

    Which all failed. Then she finally succeeds by starving herself to death? Something about this story does not add up.

  5. Neo– Here is an article about the Noa Pothoven case by Theodore Dalrymple (pen name of a British psychiatrist named Anthony Daniels) that was just posted on City Journal:

    https://www.city-journal.org/euthanasia-noa-pothoven

    He makes the same point that you do about initial reports of euthanasia being incorrect, and has some reflections of his own about the evolution of euthanasia in the Netherlands.

  6. Art Deco:

    It actually isn’t all that easy to effectively kill yourself if you use methods that don’t involve guns and/or hanging (and even those sometimes fail). Pills, for example, can be notoriously difficult and failure-prone as a method. Failure to use the most consistently lethal and violent means does not mean that a person isn’t serious; many people who ultimately succeed in killing themselves have tried and failed in the past.

    As far as whether her reported sexual attacks were real or some sort of delusion, it doesn’t matter for the purposes of this post and discussion, although it’s an interesting question. She felt they were, and they may indeed have been very real, depending on the environment around her. Whether the attacks occurred exactly as described (and I have not read her descriptions) or whether she just thought they did would be relevant if the alleged perpetrators were being charged, of course. And the question would also be relevant for any therapist working with her (and for a diagnosis and treatment plan), although one would have to take them very very seriously. But whether they occurred exactly as reported or not, they helped create the mental and physical decline that caused her to ultimately kill herself.

  7. Anorexia, which appears to have been her main physical problem, can cause brain changes that spiral into death whether the sufferer wants that to happen or not, and treatment can be very difficult and specialized.

    neo: You are spot-on here, which makes the rest of the discussion about rape, suicide and euthanasia less to the point.

    Lots of women have been raped at tender ages, even multiple times. It’s terribly tragic and they certainly have problems and depression as a result, but if they all had to kill themselves over it … well, the current grim statistics on suicide would be much worse.

  8. Maine just put the law through… will it get signed?

    Belgium allows Asperger, though one that took up the item, has now caused controversy.

    it was a hope…

  9. Without making any final judgment in this case I would note that this young woman seems to have embraced her victimhood to the point of it being an addiction. My guess is that simply could not see any other role for herself than as a victim.

  10. Somehow, along the way, I absorbed the idea that suicide is “giving up,” and the associated idea that “you should never give up,” never check out; especially since you can’t know what might happen in the future, nor if God is finished with His plans for you.

    I am very troubled by the moral aspects of the idea of assisted suicide, and although I am not very formally religious, nor am I a Catholic, if I recall correctly, Catholic theologians judge suicide to be a “mortal sin,” and likely with good reason.

    (But since the current Pope his just made a major revision to the Lord’s Prayer, perhaps Church teaching on assisted suicide is not far behind in line for a “makeover.”)

    The problem is how to judge (and who judges) who and what qualifies for such assisted suicide; what level and type of pain justifies it, what level of understanding, maturity, and mental competence does the person contemplating suicide have, what is the state of their mind—and it’s fixity, what is their medical diagnosis and just how certain is it, and/or what combination of circumstances might justify such an irreversible step.

    I’d also imagine that university trained “Ethicists” will be heavily involved in this decision, and this does not fill me with a lot of confidence.

    It is, after all, famous Princeton University “Ethicist” Peter Singer who, in 1993, said, according to the article lined below, that no newborns should be considered persons until 30 days after their birth, and that attending physicians should kill some disabled babies on the spot, and back in 1979 that “Human babies are not born self-aware, or capable of grasping that they exist over time. They are not persons”; therefore, “the life of a newborn is of less value than the life of a pig, a dog, or a chimpanzee.” *

    Then, there is the not to be ignored question of the feelings and wishes of the person considering suicide vs. the wishes of their family members/loved ones—either for or against—and how legitimate/morally right these relatives/loved ones might be (well, that gets rid of that old bat Aunt Emma/time to get the keys to her house, look it over, and start splittin’ up her stuff), how firm, reasonable, and set they might be in what they think should be done.

    To me this is just a course of action fraught with all sorts of pitfalls, and one that should be extremely carefully evaluated and supervised and, then, used extremely sparingly, if at all.

    But, very predictably, such restriction is not what is happening, as the range of cases considered suitable for this irreversible decision are apparently rapidly broadening in scope and number.

    * Peter Singer, Practical Ethics, 1st ed. (Cambridge: Cambridge University Press, 1979), 122–23. Quote taken from the larger article, “Peter Singer’s Bold Defense of Infanticide,” at https://www.equip.org/article/peter-singers-bold-defense-of-infanticide/

  11. Snow on Pine on June 5, 2019 at 5:32 pm —
    Peter Singer preached openly what a lot of people on the Left tiptoe around. There’s a certain amount of integrity in his case, horrible though his were & are in practice.

    What boggles my mind is refusing a potentially viable treatment to someone who is trying to kill themselves, because they aren’t old enough for it.
    Reason:
    As Bolwerk’s original story noted, and O’Leary summarized: “The family had tried many kinds of psychiatric treatment and Noa Pothoven was repeatedly hospitalised; she made a series of attempts to kill herself in recent months. In desperation the family sought electro shock therapy, which was refused due to her young age.”

  12. Art Deco:[Previous attempts at suicide] all failed. Then she finally succeeds by starving herself to death? Something about this story does not add up.”

    Onr of many

    … a hospital bed was set up at home in the care of her parents. At the start of June she began refusing all fluids and food, and her parents and doctors agreed not to force feed her. A decision to move to palliative care and not to force feed at the request of the patient is not euthanasia.

    In other words, “we kept her drugged up as she slowly died of thirst, rather than killing her quickly, so don’t you *dare* say that that is equivalent to euthanasia“.

  13. Still sounds more like an anorexia problem, though I imagine her rape experiences contributed to that.

    But what do you do when someone refuses fluids and food? Force them on her? Force electroshock on her? Of course, you could. But past some threshold you really can’t force people to live or at least not kill themselves.

    An old friend was a massage therapist and she worked mostly with people having serious health problems. One of her clients lost the use of his legs in a car accident. He chose to starve himself to death. Sounded crazy to my friend (and to me) but he made his choice and he saw it through.

  14. huxley:

    It is my impression that in this case the patient and her family wanted to try electroshock. Electroshock need not have been forced at that time, in her case.

  15. neo: I tend to be skeptical of electroshock, but it seems the kinder, gentler, modern version can be useful for some people and some conditions, including from what I’ve read, depression and eating disorders.

    My naive model is electroshock can jar the brain out of a negative loop.

    If this young woman wanted to try ECT, it’s a shame she didn’t get the chance, given the stakes.

  16. Snow on Pine,
    I’m not a Catholic or a fan of this Pope, but I rather approve of this change to the Lord’s prayer. As a child I was quite puzzled by the traditional wording.
    Old school Lutheran here!
    Later I read that the original Greek translates more nearly to; ‘Spare us the earth’s torture’. Which I find to be a lovely and poignant insight into the human condition.
    Amen.

  17. lion, under Dutch law there’s a massive difference between keeping a patient who chooses to die comfortable when (s)he decides to no longer accept food and drink (and often medication designed to keep them alive), and actively administering drugs that stop the heart for example.

    I fully support the first option, which my father decided on when he could no longer go on with his severe medical conditions.
    The second is troublesome, ethically, legally, and morally.
    Even in the Netherlands, where the second is legal UNDER STRICT CONDITIONS, every case has to be 1) decided by a panel of medical professionals unrelated to the doctor who will administer the drugs AND the patient AND 2) reported to the police who will investigate it (together with the medical court for professional misconduct) for whether the law was broken (and if it is the doctor responsible will be charged with manslaughter).

    My father had tried to get permission for euthanasia after he had a stroke, and was denied even though he had prior to his stroke indicated under what conditions he wanted to be euthanised, and those conditions applied, because the doctors deciding on the case determined there was still hope to get his condition improved to where he would no longer be “suffering interminably” (which is the legal definition for allowing the procedure).
    They were btw wrong in the end and his condition never improved much at all for the next 8 months until he decided to stop accepting food and medication and notified his nurses and doctors of that decision (after discussing it with me, my sister, and his medical team).

  18. Thanks, Ilion. Her mother and father are deeply implicated in this.

    Without making any final judgment in this case I would note that this young woman seems to have embraced her victimhood to the point of it being an addiction.

    I’ve seen a couple of cases in my sorry-assed life (one continuing) where the wares of the social work and mental health trade and the locus of their provision turned into a way of life (in one of these cases, steps in a dance macabre). FWIW, my gut’s telling me that the interaction between subject, parents, and professionals led to this end and if she’d had less ‘intervention’ and less ‘understanding’, they might have all been better off. I’ve seen successful and unsuccessful attempts at dealing with problem family members. The successes were superintended by men who would never consult a mental-health tradesman themselves.

  19. Still sounds more like an anorexia problem, though I imagine her rape experiences contributed to that.

    She’s assaulted 3x in three years by three sets of perpetrators in a small city in a country where the homicide rate is currently running at 0.55 per 100,000. No clue what the ratio is in the Netherlands, but in the U.S., the frequency of forcible rape is about 8x that of homicide. If that holds there, the frequency of forcilble rape would be 4.4 per 100,000. About 200,000 people live around Arnheim, so your single best guess would be that there would be about 9 rapes a year, or 27 in a three year period. Something seems really off about this young woman’s purported history.

  20. Art Deco:

    I hope you read my earlier comment to you (yesterday at 4:30) on the issue of what actually had happened to Pothoven in terms of sexual assault.

    I will add that she alleged having been raped one time and assaulted earlier. “Assault” can mean almost anything. I haven’t read her book, but I suppose you could do so if you’re really interested in the exact allegations and their credibility.

  21. NationMaster has it that the frequency of forcible rape in the Netherlands is 9.2 per 100,000.

    No data on the Netherlands. In re the U.S., the Bureau of Justice Statistics has it tht the generic category ‘sexual assault’ is 4x as common as the species ‘forcible rape’. In the U.S., about 30% of victims of violent crime are juveniles. Let’s posit the same ratios hold for the Netherlands. You have about 200,000 people around Arnheim. That suggests 18 rapes per year, forming a subset of 75 sexual assaults. If 30% of the victims are juveniles, that’s ~ 22 per year and just shy of 70 incidents over three years. Three of them involve one person who was assailed by three distinct sets of perpetrators, and she’s not merely a juvenile, but a juvenile under the age of 14. That’s an incredible run of bad luck.

  22. Art Deco:

    I think you’re ignoring my point at 4:30, which is that it is certainly possible that she was distorting, misperceiving, or even perhaps delusional about what happened to her. (That was Freud’s conclusion with similar stories, you may recall, although he originally had believed the victims). The question, however, is irrelevant in terms of what later happened to Pothoven and how she reacted to her assaults and/or her perceptions of the assaults.

    I’m not sure why you keep carping on whether she actually was assaulted or not; it’s moot because her depression was certainly very real and may have reflected a pre-existing problem or not. Certainly, as others have pointed out, not everyone sexually assaulted goes on to kill themselves. So whether her assault was real or not, her depression, anorexia, and death certainly were.

    However, I will also point out that “sexual assault” can be something rather mild (perhaps even common) and usually is unreported to the police and not reflected in the sort of statistics you’re citing.

    For example:

    The prevalence of child sexual abuse is difficult to determine because it is often not reported; experts agree that the incidence is far greater than what is reported to authorities. CSA is also not uniformly defined, so statistics may vary. Statistics below represent some of the research done on child sexual abuse…

    Studies by David Finkelhor, Director of the Crimes Against Children Research Center, show that:

    1 in 5 girls and 1 in 20 boys is a victim of child sexual abuse;
    Self-report studies show that 20% of adult females and 5-10% of adult males recall a childhood sexual assault or sexual abuse incident;
    During a one-year period in the U.S., 16% of youth ages 14 to 17 had been sexually victimized;
    Over the course of their lifetime, 28% of U.S. youth ages 14 to 17 had been sexually victimized;
    Children are most vulnerable to CSA between the ages of 7 and 13.

  23. I take the descriptive statistics of advocacy groups with a huge hunk of rock salt.

    I’m not sure why you keep carping on whether she actually was assaulted or not; i

    Did you work at Newsweek, ca. 1983? (“Genuine or not, it almost doesn’t matter in the end”).

    Why I keep ‘harping’ on it is a suspicion (1) that none of it happened and (2) her problems were partially iatrogenic and (3) partially exacerbated by her mother and father putting validation stickers on teh crazy.

  24. Art Deco:

    Your snark is misplaced. Or perhaps you just don’t understand what I’ve been saying.

    I will repeat and make it even clearer–

    Of course whether or not the assaults actually happened matters, particularly in terms of the guilt or innocence of whoever might be accused. But there’s no one accused here.

    It also would matter for a therapist working with this girl, although that person would have to tread very delicately in exploring the issue of truth vs. falsehood, misperception, or delusion, and the family dynamics that might be involved. But unfortunately that is impossible at this point, since the girl is dead.

    But it does NOT matter in terms of the facts of her depression, anorexia, and suicide, which are facts, unfortunately. The facts are that she was depressed and killed herself, and that’s the subject matter of the post and all that’s especially relevant to that discussion, as I’ve pointed out earlier. The role of her parents (and I am certain they had a role, good or bad or in-between) can be endlessly speculated on, but we know almost nothing about it and I don’t see the point now.

    The issue of whether her assaults really happened is an interesting one, and it was relevant for her life and her potential treatments. And it would have been 100% relevant if the alleged perps had ever come to the attention of authorities, of course. But that was not the situation, as far as I know. I’ve not seen it mentioned by anyone, anyway, although perhaps it was discussed in her book (which I don’t believe has been translated into English).

    But if you want to continue to talk statistics about sexual assault—of course the statistics on the incidence of sexual assault are hard to authenticate. The point I made to you is that reports to authorities are much lower than self-reports. The truth is elusive; very difficult to know. So your statistics probably represent the lowest incidence we can estimate, although I repeat that no one knows.

  25. But it does NOT matter in terms of the facts of her depression, anorexia, and suicide, which are facts, unfortunately.

    1. The suicide was aided and abetted by other parties.

    2. The causes of anorexia nervosa (if indeed she suffered it) are a mystery, so I don’t know why you’d attribute it to sexual assaults (or to fancied sexual assaults, for that matter).

    3. With regard to her depression, he moods are in part a function of her interactions with those around her, as is the manner in which she processes her moods.

  26. Art Deco:

    Your points have little to do with what I’ve been saying.

    Where did I ever attribute her anorexia to an actual sexual assault? What I wrote about her anorexia was that it was a fact, and also this:

    Anorexia, which appears to have been her main physical problem, can cause brain changes that spiral into death whether the sufferer wants that to happen or not, and treatment can be very difficult and specialized. This is a tragedy any way you look at it, and the case of Pothoven is probably an example of this phenomenon.

    And I’ve already said several times that her family setting is part of what was going on with her, as well as her perceptions.

    What’s more, in regard to her parents, as I said in my note to the original post:

    There are many many [other issues involved], including the role of parents. But I know so little about the details of this case that it doesn’t seem appropriate to comment on that. These people are suffering a great deal right now.

    Elaborating on that for the purposes of this comment, it certainly appears that her parents stood by while she starved herself to death. That is very troubling, but the reporting on this case has been so very poor that I don’t know that we know what actually occurred vis a vis the parents. It has been reported that in the past they hospitalized her, put her into an induced coma, and fed her with tubes.

    Clearly, that approach did not help. Does that mean nothing would have helped? No. But the situation was awful for the parents, too, and we really do not know what their actual role was. That is why I have emphasized the fact that they wanted her to have electroshock treatment and it was blocked by someone (doesn’t seem to have been the parents or Pothoven; seems to have been some medical person or people or government officials). That seems very tragic to me.

  27. I agree with Deco at least to the extent that this story, as it has been so far disclosed, does not add up.

    But something about this young woman, on the surface at least, creeps me out … there is an almost … theatrical seeming aspect to her savage (look at those arm scars – if that is what they are) persistence, and her abundant self-consciously portrait-like images.

    I stipulate that I am only familiar with what I have read. But what has been presented, just does not make sense.

  28. DNW:

    It makes sense as a story of mental illness of unknown etiology, that was handled in a way that did not help and that ended in a suicide. Whether anything could have changed the course of events and prevented that suicide I do not know (no one knows). But I know that not everything was tried.

    As I’ve written to Art Deco, it is impossible to know whether this young girl was actually sexually assaulted, and what (if any) role that played in the development of her myriad problems. Therefore I have focused on the problems themselves, and what I see as one particular and apparently glaring failure of the system that was supposed to have helped her: the refusal of authorities to allow her to have electroshock therapy, which can be very helpful in the case of previously intractable depression (which is what she apparently had, despite what we don’t know about her).

  29. I made a comment earlier, lost in the spam filter I imagine, but my sister was incested by our stepfather multiple times as a pre-teen. She ended up with an eating disorder and has been suicidal a few times. She has had a hard life and it’s not a mystery to me where much of that came from. She didn’t report her rapes to my mother or the police either.

    So Pothoven’s story makes sense to me, though what really happened is likely impossible to prove at this point.

    I do wonder how much of a factor anorexia was. As neo has noted, anorexia can cause “brain changes which spiral into death.”

    Her self-promotion as a victim — publishing a book while a teenager about this horrible stuff — bothers me. It may have cemented her sense of self with trauma. I’ve read some research to the effect that reliving trauma makes things worse instead of better.

    I worry that our society’s elevation of victimhood is making it harder for people to get over stuff and may in fact be greasing the skids for people to choose resignation over resilience.

  30. Where did I ever attribute her anorexia to an actual sexual assault?

    Now you’re being lawyerly.

  31. Art Deco:

    Resorting to ad hominem attacks now, are we? I am making the point that you appear to be attributing words and thoughts to me that I did not express, so you dismiss what I’m saying by calling it “lawyerly”?

    That’s one of the weakest arguments in the book, as you well know.

    What’s more, lawyers are many things, some of them not so good (at least, most lawyers). But when you want one in your corner you are very happy for them to be “lawyerly”—whatever that means. One of the things it can mean is “logical and factual.” I make no apologies for being logical and factual. I ask the same of commenters here.

  32. Neo says,

    DNW:

    It makes sense as a story of mental illness of unknown etiology, that was handled in a way that did not help and that ended in a suicide. Whether anything could have changed the course of events and prevented that suicide I do not know (no one knows). But I know that not everything was tried.

    No doubt. It is particularly disquieting, as you point out, that electroshock was disallowed because of age, yet a virtual pantomime of in-home hospice was thought suitable.

    Shoot them up with morphine and let them dehydrate to death? Not even with my 91 year old mother or father. And the hospice nurses remarked to me that the one point that virtually all people balk at when allowing a “natural death”, is the withholding of fluids and nutrition. Forgoing surgery, radiation, or even medicines at some point, can be processed as moral options. But assisting someone to die of thirst by stupefying them?

    Anyway this girl seems to have had a constellation of issues, as well as an almost feral will to die, that, I suspect, and only suspect, had some component of perverse, rebellious, and nihilistic egotism to it. Maybe she was so driven that she would have gone to a shopping mall and publicly disemboweled herself.

    I freely admit that what I have thus far seen is only a mediated and fragmentary representation of whatever reality she and her family experienced.

    But even someone who usually disagrees with me, and seems to have no particular religious commitments or leanings, seems to experience a sense of moral queasiness, as he well stated …

    “Her self-promotion as a victim — publishing a book while a teenager about this horrible stuff — bothers me. “

  33. DNW:

    Unlike the situation with Pothoven, usually when people stop eating and drinking it is because they are dying—already well into the dying process—and their bodies are unable to absorb nutrients properly because the body is shutting down. There have been countless studies and countless papers written on whether giving fluids and/or nutrition through tubes at that point helps relieve the patient’s suffering or causes prolonged suffering. I have read a lot of that literature. If you haven’t, you might want to. You may or may not believe the studies of those who say it only prolongs suffering and does no good at all. But it is a very common conclusion of such studies.

    Just to take an example, from this article:

    Are there any beneficial effects of dehydration?

    Dehydration can actually have several potential benefits for a person who is at the end stages of his/her life:

    Secretions in the lungs are diminished, so cough and congestion are less, and procedure.
    Dehydration can lead to a melting away of the swelling and increased comfort in a person who has edema (swelling of the body caused by excess body fluids) or ascites (fluid in the abdominal cavity).
    With dehydration, there is less fluid in the gastrointestinal tract, which may decrease nausea, vomiting, bloating and regurgitation.
    A dehydrated person has less urine output, thus less need to go to the bathroom for extremely weak and frail patients and less skin irritation when the bedbound person develops incontinence. There is also less need to place a foley catheter in such a person. Foley catheters are irritating, can cause extremely painful bladder spasms, and are known to increase the risk of serious infections of the urinary tract and body.

    Are there any situations in the seriously ill where artificial nutrition and hydration are helpful.

    There are situations where artificial nutrition and hydration, in a specific person and in specific situations, are likely to be more beneficial than harmful:

    A person who has a mechanical blockage of his/her mouth, esophagus, or stomach, but is otherwise functioning fairly well, especially if this person is experiencing hunger, is likely to benefit if a tube is placed below the blockage in order to be able to receive nutrition and fluids. This is the case in many persons who suffer from head and neck or esophageal cancer, especially in the earlier stages of the cancer.
    In some cases, when a blocked bowel develops, such as in spread of ovarian cancer, but the person is otherwise fairly functional, TPN has been helpful in allowing that person to live and function longer than without the treatment.
    A person who has a temporary bout of severe nausea and vomiting or has diarrhea causing serious dehydration can often benefit from a short course of intravenous fluids to rest the bowel.
    Evidence is conflicting in some persons with cachexia due to HIV disease. Some persons appear to benefit from artificial nutrition and hydration, especially those who have no active infection at the time of receiving it.

    From time immemorial, human beings have expressed their love for one another through the act of feeding and sharing meals. Much of the anguish over decisions to start, withhold, or discontinue artificial nutrition and hydration stems from a mistaken feeling that the act of administering artificial nutrition and hydration is equivalent to the nurturing acts of feeding our babies or serving a meal to our family.

    Artificial nutrition and hydration is a medical treatment, with intended beneficial effects but many side effects and complications attached to its use. Decisions about its use need to be based on a dispassionate look at what, if any, benefits will occur, what side effects and burdens are likely to occur, and what the individuals’ and families’ goals are for the treatment.

    When artificial nutrition and hydration is more likely to be burdensome than helpful, it should be avoided or discontinued. Nurturing can be expressed in more helpful ways, such as gentle presence, touch, talking with the person (regardless of his/her ability to respond), keeping the person’s lips and mouth moist, gently massaging the skin using lubricants, praying with the person, or playing favorite music selections.

    And here you can find a very thorough and comprehensive discussion of the issues and the evidence. If you read it you can see it’s quite complicated and somewhat counter-intuitive in certain respects.

    You mention “assisting someone to die of thirst by stupefying them.” That isn’t the way it works; I’ve never seen anything like that, and I’ve seen several people undergo death without hydration and I’ve read a lot about it as a result. What is actually happening (in my experience, and in my reading) is this: the person is already well into the process of dying before any sort of sedation begins. Sedation often isn’t necessary because the person is already mainly sleeping. But if sedation is given, it is for one of these three reasons (or some combination of them): tremendous pain, extreme mental agitation and terror (agitated delirium), and/or air hunger (struggling to breathe). Only enough is given to ease the symptoms, which are almost unbearably awful—and the patient ordinarily is already neither eating nor drinking. So the patient is sedated to ease an enormous amount of suffering, the patient is already well into the process of dying, and the patient is already neither eating nor drinking (or, if doing either, is doing so little that it is irrelevant). You will see from the articles that the patient’s body is actually shutting off in terms of the kidneys being able to process fluids, for example.

  34. I once was on the “death watch” for an elderly man, Alfred, from my church who was dying of advanced cancer. I forget what kind, but he was riddled with it and he was dying. I was one of the people who would stop in and see how he was doing and how I might help. Alfred was a lovely fellow.

    At one point the rector told us that Alfred had stopped taking food and fluids. I don’t know what drugs he may or may not have been on. It was as much to avoid the problems of getting him to the bathroom and back as anything else, as I recall.

    But Alfred was dying and there was nothing anyone could do besides provide whatever small comfort and honor his passing.

  35. indeed Huxley, and that’s how it should be. Force feeding people who have a declared wish to die is immoral and unethical.
    Not giving them help to ease their suffering is similarly immoral and unethical, be it painkillers, prayer, or whatever help you can offer.

  36. Neo says,

    “You mention “assisting someone to die of thirst by stupefying them.” That isn’t the way it works; I’ve never seen anything like that, and I’ve seen several people undergo death without hydration and I’ve read a lot about it as a result. “

    Well, that is the impression I received from outside some reading of what was done in the instant case. The girl refused to eat or drink, and they gave her meds to make her more comfortable. In other words, and on my reading, to make starving and dehydrating to death more tolerable.

    And yes in the case of the elderly, I know a bit about this. I had a number of nurses tell me as I stood by the bedside suggesting this or that tactic, that, “Your mother (and father) is not taking fluids because they are dying; they are not dying because they are not taking fluids”

    I put my father on a feeding tube (nasal, and inserting that was a trauma) as a last attempt to build up enough strength in him to eat. It ultimately didn’t work to the extent of revivifying him. So I had the tube pulled and told him I was taking him home and we would do whatever he wanted. But he died the next day … on Father’s Day last.

    He had really not been able to eat for almost a month, and prior to that he was “pocketing” food. I even brought caregivers from home to sit with him in the hospital and slowly feed him. It worked to the extent that over a couple hours he could get a some mashed potatoes and a nutrition cup down, but that was about it.

    I still don’t know whether I was right or wrong in not insisting on an abdominal feeding tube. What people will swear they will never allow done at a cocktail party at age 59, is rather different from what they will agree to at 91, “If it’s really necessary”

    I suppose death will get us all. I just hate that mealy mouthed kumbayaist “death is part of life” bullshit. It is the enemy. Makes me so mad I could …

  37. One fun thing I remember about Alfred is he still had a white, vintage ’60s Mustang, which he drove around San Francisco into his late seventies. He said he was regularly approached by people in parking lots and on the street who wanted to buy it.

    Alfred was a gay man of deep faith who attended Episcopal mass daily, or as often as he could. He described his moment of conversion from being a Christian on paper to a real Christian: a bright, golden light of forgiveness from God came down upon him and in tears he was changed.

    He had a gentle, at times risque, sense of humor. One of the funniest stories I heard was five years previous when he had come out of the hospital from a colonoscopy. The following Sunday he stepped up to the microphone during the church announcements and quoted from his doctor’s sheet of instructions, that he was to “5. Resume sexual activities.”

    Then he raised high a sheaf of fanfold computer paper, said, “I have a sign-up sheet for volunteers,” and released the paper to unfurl down to the floor. The rector practically fell out of her chair and half the women signed up at coffee hour, though I didn’t hear if any of the men did.

  38. DNW:

    Pothoven committed suicide, which isn’t relevant to the question of what is done by the medical profession under more ordinary conditions of imminent death and not taking in fluids.

    But I find those articles fairly convincing in terms of not feeding or hydrating through tube when death is clearly very imminent and suicide is NOT involved. It’s not at all an easy decision, but it seems that those things do more harm than good on balance. We really can’t know, though, and the entire process is awful.

  39. Resorting to ad hominem attacks now, are we?

    The term ‘ad hominem’ does not mean what you think it means.

  40. “Alfred, from my church who was dying of advanced cancer. I forget what kind,…”

    Aren’t you a Buddhist?

  41. DNW:
    Pothoven committed suicide, which isn’t relevant to the question of what is done by the medical profession under more ordinary conditions of imminent death and not taking in fluids.”

    I don’t think we actually have much of an argument here.

    I’m not for pouring water into the lungs of people who cannot swallow; nor for keeping people who are obviously “end of life” on IV’s indefinitely.

    But Pothoven at 17, was, I have read, given drugs to make her suicide by self-starvation and dehydration more tolerable. That, is what I am condemning. She was enabled.

    A couple or three stipulations.

    1. I don’t know anything about her real situation. All I know is what I have taken away from a number of articles on her.

    2. If the assertions printed about her case were true, then I think that there was something incredibly creepy (morally disturbing, not just medically unusual) going on with her psychology and her parents’ and her government’s handling of her.

    3. In a sense I don’t really care what she, personally, did. What I do care about is ensuring that this demented, thanatic urge, (with its apparently huge dollop of drama) is not turned into some kind of social phenomenon like homosexuality, which people then start demanding we affirm as a respectable moral choice, just because they say they have an itch which in “their reality” requires scratching.

    Yeah … so what …

    I do of course recognize that some people are in love with, perhaps theatrically in love with, death. I care, but not too much, about what happens to them.

    I care much more about the spillover effects of their demanding that their nihilism be affirmed and participated in.

  42. Art Deco:

    No, Art Deco, the term does not mean what YOU think it means.

    This is what it means. I am sure you can find some more restrictive meaning that suits your fancy and your purposes, but this is what it means [emphasis mine]:

    1.(of an argument or reaction) directed against a person rather than the position they are maintaining.

    short for argumentum ad hominem, is a fallacious argumentative strategy whereby genuine discussion of the topic at hand is avoided by instead attacking the character, motive, or other attribute of the person making the argument, or persons associated with the argument, rather than attacking the substance of the argument itself.

    Saying an argument is “lawyerly” is not refuting the substance of the argument at all. You made no attempt to refute my point with logic or evidence, merely with what you consider to be an insult about style reflecting in some supposed way my training in law and legal argument. Nothing to do with substance; everything to do with another “attribute of the person making the argument.”

    I have a great deal of tolerance for the foibles of regular commenters here, but gratuitous insults are treading on troll territory, and at this point you’re wasting my time.

  43. DNW:

    I haven’t read that she was given drugs, but I certainly haven’t read everything written about her death, so I don’t know. Do you have a link?

    If the drugs were self-administered, do you think that’s different?

    I find almost all aspects of her case troubling. I agree that there is the possibility of its having been mishandled on almost every level. That said, it is astoundingly difficult to treat someone profoundly depressed and determined to die. In her case, I don’t believe everything was tried (particularly electroshock). But other than that, I really don’t want to speculate because I just don’t have enough information.

    I would assume that if I read her book I’d know more. I agree that it’s possibly troubling that her book was published in the first place, but I’d have to know more about that, as well. I don’t think it was translated into English.

  44. “DNW:
    I haven’t read that she was given drugs, but I certainly haven’t read everything written about her death, so I don’t know. Do you have a link?”

    I read so many articles they tend to blend together and I cannot access my history at the moment.

    Nonetheless the critical term here palliative sedation which is implied as admitted in passing, while”euthanasia” is voluminously rebutted. as you can see by accessing the BBC article at the link below

    https://www.bbc.com/news/world-europe-48541233

    You might also find this article interesting. https://www.gelderlander.nl/home/noa-16-uit-arnhem-is-nu-al-klaar-met-haar-verwoeste-leven~a01a7bd1/ Google will translate it.

    To get the full flavor of the problem, you have to read the girl’s “bucket list” which is so thoroughly and trivially secular that it almost leads one to believe that that is part of the problem.

    Furthermore, she apparently refused to tell the police anything about the two men who supposedly raped her. And whether it is an artifact of translation or something else, her description of the “sexual assaults” she experienced read very strangely.

    She is very vehement that her will was violated as well as her body, but at the same time she will do nothing about seeking justice.

    “In her book, Noa writes that she was assaulted at a school party when she was 11 and another year later at a teenagers party.

    “It is the second time that a man was sitting against me, against my will, in intimate places.”

    At the age of 14, she writes, she is raped in the Arnhem neighborhood of Elderveld by two men. At home she says nothing about it. “Out of fear and shame,” she says now. ,, I relive the fear, that pain every day. Always scared, always on my guard. And to this day my body still feels dirty. My house has been broken into, my body, that can never be undone. ”

    At the time, she did not report it. But recently she did report the matter to the police. ,, No, I have not made a declaration. I can’t, “says Noa.

    “She has to tell the police in detail what those men have done to her,” her mother says. ,, She still finds that too difficult. Too confrontational. She doesn’t get the word ‘rape’ out of her mouth yet. “”

    Lisette hopes that the perpetrators will be caught someday. ,, They should know what they did. ” …

    DNW [Discussion of the lack of institutionalization therapy in the Netherlands is reviewed, followed by ….]

    ” …She has almost completed her bucket list, her list of things she wants to do someday. Fourteen of the fifteen wishes have been fulfilled. ,, No big things, though. Such as riding a scooter for the first time, smoking a cigarette, drinking alcohol and having a tattoo. I have the text ‘You should not believe everything you think’ put on my body by Loesje.

    ,, There is one wish left: eating a bar of white chocolate. That is my favorite candy, but I haven’t tasted it in years. That is because of my anorexia. I don’t dare to eat it yet. That is because of the fear of getting fat. “”

    The book
    Noa’s book is ready, it is printed. But it is a book with an open end, she writes at the end. She gives trauma therapy ‘one last chance’. She hopes for ‘a miracle’, but she thinks it is probably hope against knowing better. If that also fails, then life has nothing to offer her.

    Her parents are afraid that she will harm herself. Two weeks ago another suicide attempt was thwarted. Noa’s death wish is stronger than her urge to survive. The parents therefore live by the day, hoping that Noa will ‘see bright spots again’, ‘perhaps fall in love’ or learn to discover that ‘life is worth living’.

    Yeah, maybe they could tell her that it is wrong to kill yourself. But then again, that is probably going a bridge too far in Holland.

  45. Aren’t you a Buddhist?

    DNW: I have no idea how you put that together. No, I am not a Buddhist.

    Pleased to meet’cha. Hope you guess my name. But what’s puzzling you is the nature of my game.

  46. I did meditate at the San Francisco Zen Center for a while, but that was while I was a programmer during the dotcom bubble. Getting to the Center at 4:30 am for zazen made me even crazier, so I stopped.

    However, I was friends, and there were so many of us, with a Zen priest, Darlene Cohen. She was something special. She died eight years ago. So loving, yet upfront and human. “Right. Now that I’m dying, everyone wants to be my student!” Or words to that effect. She was something special.

    https://web.archive.org/web/20130619145416/http://sweepingzen.com/still-manifesting-dharma-darlene-surei-kenpo-cohen-october-31-1942-to-january-12-2011/

    Darlene developed terrible arthritis in her thirties such that she was in chronic pain for the rest of her life. I saw her when I was dealing with chronic pain, though not like hers.

    She was so full of life and kindness. I only wish Noa Pothoven could have met Darlene or someone like her. Or maybe she did and couldn’t open to the gift.

  47. “DNW: I have no idea how you put that together. No, I am not a Buddhist.”

    Yes you are. How dare you deny it! LOL

    Oh … The mention of yoga, and probably Zen. San Francisco, pot, hippies, a commune … possibly an unjustified surmise nonetheless. But a more or less reasonable impression, eh?

    Now, I never studied Zen. But I was given a copy of D.T Suzuki’s famous book on Zen and read it through a couple of times.

    I was impressed, and thought that there might be some possibility that the discipline could be integrated with or related to phenomenology; which had a theory and a procedural outline, or at least program, but no real method so far as my classroom work revealed.

    Maybe, staring at an object until it disappeared – or rather until its familiar socially contexted aspect disappeared – could be an insight into a process – if not of peeling back the layers of consciousness, then at least a kind of route to something analogous to epoché.

    https://www.iep.utm.edu/phen-red/#SSSH5a.i.1

    I was not even thinking of satori or any of that.

    Then much later, I read that Suzuki, whatever it was that he was preaching, was not considered to be preaching real Zen, much less Buddhism. And from what little I know of Tibetan Buddhism and all its weirdness, a stripped down, abstracted method akin to experimental epistemology, with no spiritual dimension to its metaphysics, would have been just fine with me anyway

  48. DNW: I’m old-fashioned that words mean things. No, I’m not a Buddhist. Nor are most people in San Francisco who might have been hippies, lived in communes, done yoga or smoked pot. I’m a seeker and it’s one of the places I sought. Darlene Cohen was the only Buddhist I’ve known personally.

    As to D.T. Suzuki and all the who’s preaching the real Zen or the real Buddhism — that’s as messy a business as the real Catholicism or the real Christianity.

    Zen is not simple and it certainly has its warts. A strong criticism of D.T. was his support for Hitler and Japanese nationalism, but then most Zen masters of that time were in that camp.

    An exception was Shunryu Suzuki, who couldn’t get with the program and eventually moved to America and started the San Francisco Zen Center, which became the mother ship of American Zen.

    S. Suzuki wrote an utterly stripped-down, landmark account in English of Zen practice titled, “Zen Mind, Beginner’s Mind,” which I’ve never seen criticized. It might not fit in with your phenomenological quest, but you will be drinking milk from the cow.

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