Citizens group argues 'right to die'
A citizens action group wants to legalise assisted suicide for all people over 70.
All Dutch people over 70 years of age who feel tired of life should have the right to professional help in ending it. This is the demand of a citizens' initiative in the Netherlands calling itself “Out of Free Will”. It will start collecting signatures on Tuesday to lobby for a change in legislation, hoping to place the matter firmly on the parliamentiary agenda.
A number of prominent Dutch citizens have come out in support of the initiative, including former ministers and artists, legal scholars and physicians .
The group hopes to decriminalise assisted suicide in the Netherlands. Under current Dutch law, euthanasia is only legal in cases of “hopeless and unbearable” suffering, which means it is limited to people suffering from serious medical conditions and in considerable pain. Only doctors are allowed to assist in euthanasia. It is illegal to help somebody commit suicide who does not meet the qualifications stipulated in the current euthanasia law. The Netherlands legalised euthanasia in 2001, one of the few countries in the world to do so.
A new medical trade
The newly founded citizens initiative does not only want to decriminalise assisted suicide, it wants to found a new profession to assist those weary of life. The group has suggested this task be carried out by specially trained and certified nurses, psychologists or spiritual professionals who can confirm the request for assisted suicide via a series of conversations with the elderly patient. Only after a second health care professional has confirmed the patient’s death wish would he be provided with lethal drugs. The same caretaker would finally supervise the patient as he administers these to himself.
The group paints the following scenario: The specialists should ensure that the patient is of sound mind and that his or her request is explicit, logical and consistent. The suicide assistants must make sure the death wish is more than a rash impulse, the product of depression, or the symptom of another illness, and that the patient has considered the consequences of his actions for those who will survive him. Once the patient has taken his own life, the suicide assistant must write a report that can be reviewed by the municipal coroner. The case is then assessed by the regional euthanasia approval commission, which has already been set up to oversee the application of the current Dutch euthanasia law.
“Out of Free Will” visualises that health care professionals looking to assist in suicides will need to complete a special “Completed Life” training programme and join a professional association responsible for maintaining standards of professional, transparent and safe conduct. The group argues that suicide assistance should only be provided to Dutch citizens. Currently, an estimated 400 elderly take their own lives every year, sometimes by violent means.
Enjoy old age– up to a point
During an interview in the office of Dick Swaab (65), a leading member of the group and the managing director of the Amsterdam-based Netherlands Institute for Neuroscience, three of the initiative’s prominent supporters explained why they felt suicide assistance should be made legal. Former minister and self-described feminist, Hédy d’Ancona (72), said arguing for the right to choose one’s time of death was a natural extension of her lifelong battle for emancipation. Legal scholar, Eugène Sutorius (63), said he considered the right a cultural matter, and that he was looking for freedom to face death “in a stoic manner”, without fear of a legal system that qualified assisted suicide as a crime, or the dread of ending up in a care facility resembling a prison. For neurologist Swaab, death is a rather straightforward matter. “Throughout the animal kingdom, individuals are simply replaced, rather than patched up endlessly,” he explained. Aging constitutes nothing more than “cells wearing out through use,” Swaab said. His argument: when you feel you have no more life left in you, you should be able to say so, and act on it.
All three expressed enthusiasm about ageing. Everything becomes easier to put into perspective as time passes, they said. Sutorius called it an “immense pleasure”. D’Ancona referred to it as “a great phase of life.” But they also expressed fear of what is still to come. D’Ancona said the knowledge she would be unable to end her life when she wanted to left her with a “nagging feeling”. She said it took some of the enjoyment out of what was otherwise a pleasurable phase of her life. Sutorius, too, feared a moment would soon come when he would come to experience the drawbacks of ageing. “I do not want to outlive myself,” he said.
Completed life – time to end it?
The citizens action group refers to a moment when “life is completed”: the lack of purpose that elderly people experience when their family, friends and acquaintances have all passed away, when they feel left behind, unable to escape an empty existence. As early as 1991, Dutch Legal scholar, Huib Drion, proposed providing the aged with an “acceptable means to end their lives at a moment they see fit”. Opinion polls lead the citizens initiative group to believe broad popular support exists to make this option law. The issues that would arise from such a move are surmountable, the group feels.
What about the risk of abuse? The elderly may find themselves being pushed into taking their own lives by an unsupportive social circle. Wouldn’t legalising suicide assistance be taking things one step too far? Sutorius denied this in the interview, calling the group’s proposal “a step in the right direction”. Lifting the burden of suicide assistance from doctors’ shoulders would help these keepers of life steer clear of difficult situations. According to Sutorius, criminal law has little bearing on assisted suicide for people over 70. Responsible, transparent assisted suicide, carried out in a proper manner, is light years removed from the capital offences listed in the criminal code, he said. “No one stands to win or gain personally from it, and there is no disproportional violence involved that harm other peoples’ interests.”
Still, criminal law knows a plethora of cases involving so called “angles of death”: nurses or doctors who took to (mercy) killing of their patients. According to Sutorius, “illegitimate coercion” can never be ruled out completely. The law can only do its best to fight it. Sutorius recalled that the introduction of legal euthanasia in the Netherlands was also previously seen as a corruption of medicine. “It was thought to be the first step on a slippery slope that would lead the medical profession to lose its integrity. But I have seen nothing of the kind happen.”
Only for 70 and over
The group wants to draw a line at age 70. Helping young people commit suicide “cannot be justified,” Sutorius said. When a younger person kills himself, it is always “a disaster”, hesaid. “An older person can understand more, has more perspective.”
The group admits the age of 70 is a somewhat arbitrary cut-off point. “Whether it should be 65 or 90 is a good question,” Sutorius said. “We think that once someone has reached old age, he has proved abilities at living. He can then choose to leave this life in a procedural, medicalised manner.”
The three supporters of the initiative think the proposed profession of suicide assistant would be somewhat like “taking a walk with death”. A job advertisement would sound something like this: “Wanted: nurse or spiritual caretaker in possession of a Completed Life Certificate”. Who would respond to such an ad? “I would not hesitate to do so myself,” Sutorius said. "You would be guiding someone to death at his express request, in the most humane way possible,” D’Ancona added.
Still, since suicide itself is not illegal under current law, why would anyone want to burden another person with the taking of his life? Because, Swaab explained, “you need to know how much of what you need take”. Usually, the required drugs are not hard to come by, and, under current law, relatives usually procure the lethal drugs, sometimes with help from a physician who has been tricked into providing them under false pretences. Also, a do-it-yourself suicide leaves ample room for error. “Current practice is in no one’s interest,” Sutorius said. “Also, people might act on a whim. Or because they are depressed or otherwise ill and unable to oversee their own situation.” Suicide assistance might also help to prevent people from taking their own life, Swaab added.