Last year, a young Dutch lady was busily crossing calendar days off a whiteboard in her home, in expectation of the big day. She made sure to pencil in last-minute trips with her loved ones, days for her favourite hobby arts and crafts, and even a few bike rides in her local park - she was, after all, a very fit and healthy woman and by all accounts, had an outwardly nice life.
But she bore a silent agony, having struggled on and off with clinical depression since the age of 12, psychosis, borderline personality disorder and suicidal thoughts. She was often distressed and would habitually self-harm. And in this state of mind, which - unlike her body was not healthy - this young woman had made a decision and ticked a box giving her consent.
Finally, the day she had been awaiting for months arrived. She entered a clinic, carrying a toy dinosaur in her arms, lay down on a bed in a white room and drank poison supplied by a doctor. And so, with medical assistance, at the age of 29, Aurelia - fit, healthy and not in any physical pain but in a very poor state of mental capacity - was voluntarily euthanized.
The case sparked controversy in the Netherlands, a country where euthanasia has been legal for 20 years and is generally viewed as a test case for the practise. The law was originally passed for patients experiencing “unbearable suffering with no prospect of improvement”. No matter our own views on euthanasia, whether prefixed on secular or religious grounds, I'm sure that we can all see the rationale of granting voluntary euthanasia to a person with terminal lung cancer, for instance, whether or not we think it should be legal.
But Aurelia's case is altogether more troubling and becoming more routine. Everyone in the Netherlands now seems to have known someone who has been euthanized. “In the coldest weeks of last winter,” Dr. Theo Boer told the Guardian newspaper, “a doctor friend of mine was told by an elderly patient: ‘I demand to have euthanasia this week – you promised.’ The doctor replied: ‘It’s -15C outside. Take a bottle of whisky and sit in your garden and we will find you tomorrow, because I cannot accept that you make me responsible for your own suicide." This doctor, Boer said, once performed euthanasia three times annually. He has now stopped altogether, part of a growing caucus of medical professionals who are questioning whether it does now conflict with their Hippocratic Oath.
"How could I know - how could anybody know - that her death wish was not a sign of her psychiatric disease? The fact that one can rationalise about it, does not mean it's not a sign of the disease," said psychiatrist Dr Frank Koerselman, with regards to Aurelia.
The sad case of Aurelia is not an isolated aberration either. Many healthcare professionals in the Netherlands are beginning to worry about the unforeseen ramifications that euthanasia is having in their country and wider culture. Last year, in the wake of Aurelia's case, a medical ethicist called Berna Van Baarsen publicly resigned from one of the review boards at the 'End of Life' clinic in protest at the growing rate at which dementia sufferers were being euthanized on the basis of written directives that they are unable to confirm after losing their faculties. “It is fundamentally impossible,” she told the newspaper Trouw, “to establish that the patient is suffering unbearably, because he can no longer explain it.”
In one widely distributed case, a dementia sufferer had asked to be killed when the “time was right” (a shockingly vague request) in an advance directive. Her doctor then judged the time "to be right" but the patient resisted, vigorously, claiming that she was still of sound mental capacity to know when she wanted to die, and that she didn't want to die. In response, she was drugged and physically restrained by her family until she submitted to the doctor’s fatal injection.
When this case came to review, the doctor who administered the fatal dose – whose identity has been concealed under law, in case the doctor is subjected to public attack – has defended their actions by saying that it was in strict fulfilment of the patient’s prior request and that, since the patient was "incompetent", her protests before death were irrelevant, as heartrending as the spectacle of a woman being dragged to her death, seemingly unwillingly, might have proved for all involved.
Now, I am a Catholic and so anticipate that some will deem my perspective on this matter to be incorrigibly biased by my religious principles. That is perfectly fine, I don't deny that my faith tradition influences my moral judgement in this area. But the doctors I have mentioned here do not fall into that category - they were, and still are to an extent, supporters of euthanasia in principle. Yet they think it has gone too far and worry that the "slippery slope" argument has proved right after all, with perhaps irreparable damage being done to Dutch societal approaches to the experience of death.
At what point does "the right to die with dignity" become the mark of a culture that has lost respect for the dignity of human life? What does the act of killing a physically healthy young person, or an old person with dementia who no longer wants to die but is deemed unfit to withdraw consent, tell us about our own views of human wellbeing?
What do you think about this issue? Is euthanasia or its cognate assisted dying legal in your country or state? If not, do you think it should be? Why or why not?
But she bore a silent agony, having struggled on and off with clinical depression since the age of 12, psychosis, borderline personality disorder and suicidal thoughts. She was often distressed and would habitually self-harm. And in this state of mind, which - unlike her body was not healthy - this young woman had made a decision and ticked a box giving her consent.
Finally, the day she had been awaiting for months arrived. She entered a clinic, carrying a toy dinosaur in her arms, lay down on a bed in a white room and drank poison supplied by a doctor. And so, with medical assistance, at the age of 29, Aurelia - fit, healthy and not in any physical pain but in a very poor state of mental capacity - was voluntarily euthanized.
The case sparked controversy in the Netherlands, a country where euthanasia has been legal for 20 years and is generally viewed as a test case for the practise. The law was originally passed for patients experiencing “unbearable suffering with no prospect of improvement”. No matter our own views on euthanasia, whether prefixed on secular or religious grounds, I'm sure that we can all see the rationale of granting voluntary euthanasia to a person with terminal lung cancer, for instance, whether or not we think it should be legal.
But Aurelia's case is altogether more troubling and becoming more routine. Everyone in the Netherlands now seems to have known someone who has been euthanized. “In the coldest weeks of last winter,” Dr. Theo Boer told the Guardian newspaper, “a doctor friend of mine was told by an elderly patient: ‘I demand to have euthanasia this week – you promised.’ The doctor replied: ‘It’s -15C outside. Take a bottle of whisky and sit in your garden and we will find you tomorrow, because I cannot accept that you make me responsible for your own suicide." This doctor, Boer said, once performed euthanasia three times annually. He has now stopped altogether, part of a growing caucus of medical professionals who are questioning whether it does now conflict with their Hippocratic Oath.
"How could I know - how could anybody know - that her death wish was not a sign of her psychiatric disease? The fact that one can rationalise about it, does not mean it's not a sign of the disease," said psychiatrist Dr Frank Koerselman, with regards to Aurelia.
The sad case of Aurelia is not an isolated aberration either. Many healthcare professionals in the Netherlands are beginning to worry about the unforeseen ramifications that euthanasia is having in their country and wider culture. Last year, in the wake of Aurelia's case, a medical ethicist called Berna Van Baarsen publicly resigned from one of the review boards at the 'End of Life' clinic in protest at the growing rate at which dementia sufferers were being euthanized on the basis of written directives that they are unable to confirm after losing their faculties. “It is fundamentally impossible,” she told the newspaper Trouw, “to establish that the patient is suffering unbearably, because he can no longer explain it.”
In one widely distributed case, a dementia sufferer had asked to be killed when the “time was right” (a shockingly vague request) in an advance directive. Her doctor then judged the time "to be right" but the patient resisted, vigorously, claiming that she was still of sound mental capacity to know when she wanted to die, and that she didn't want to die. In response, she was drugged and physically restrained by her family until she submitted to the doctor’s fatal injection.
When this case came to review, the doctor who administered the fatal dose – whose identity has been concealed under law, in case the doctor is subjected to public attack – has defended their actions by saying that it was in strict fulfilment of the patient’s prior request and that, since the patient was "incompetent", her protests before death were irrelevant, as heartrending as the spectacle of a woman being dragged to her death, seemingly unwillingly, might have proved for all involved.
Now, I am a Catholic and so anticipate that some will deem my perspective on this matter to be incorrigibly biased by my religious principles. That is perfectly fine, I don't deny that my faith tradition influences my moral judgement in this area. But the doctors I have mentioned here do not fall into that category - they were, and still are to an extent, supporters of euthanasia in principle. Yet they think it has gone too far and worry that the "slippery slope" argument has proved right after all, with perhaps irreparable damage being done to Dutch societal approaches to the experience of death.
At what point does "the right to die with dignity" become the mark of a culture that has lost respect for the dignity of human life? What does the act of killing a physically healthy young person, or an old person with dementia who no longer wants to die but is deemed unfit to withdraw consent, tell us about our own views of human wellbeing?
What do you think about this issue? Is euthanasia or its cognate assisted dying legal in your country or state? If not, do you think it should be? Why or why not?
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........... so I thought he was safe for the time being. So much for my assessment. That still hurts.
