Should the state facilitate assisted suicide when someone develops a death wish on account of the prospect of needing a wheelchair? And what should the response be when, if it involves a couple, one of the two partners has this prospect and will likely need to move to a nursing home, so that the couple can no longer live together as before? Should there be a state-regulated organization to fulfil their shared wish to die?
Athol (80) and Beverly (79), an Australian married couple, were confronted with this future scenario. Athol ruled out going through life in a wheelchair, and Beverly ruled out ever pushing him around in a wheelchair. They also ruled out ever living separately from each other, with just him in a nursing home – but also refused to consider moving into a nursing home together. As they were no longer able to lead the life they were used to but could not make use of any euthanasia arrangement, they decided to commit suicide together. They did so in a hotel room in Peru, where they could easily obtain the required substances. They did so without any state assistance, but strongly believed that such assistance ought to have been provided.
The leading Dutch newspaper NRC Handelsblad, generally viewed as classic liberal in outlook, highlighted this case in a report in May 2018 titled Ons voltooide leven (‘Our completed life’). Dutch friends of the Australian couple had some video footage, which the newspaper incorporated into a bilingual Dutch/English online documentary. For readers wishing to view the documentary titled ‘Death with dignity’, go to here.
Those wishing to read to the accompanying long-read titled ‘Beverly and Athol’s final decision’ (a multi-media version of the report), this is the link.
The Dutch debate on assisted suicide
In the Netherlands, a death wish like Athol and Beverly’s is currently framed within a specific political context, namely that of ‘self-determination’ and the ‘right to assistance’. The newspaper report explains the political situation to readers of the long-read article: “There is no legal provision for relatively healthy people who feel they are ready for their lives to end, though the Liberal Democratic D66 party is currently developing draft legislation on this issue”.
This case, too, is framed in terms of a discourse in which ‘completed life’ and ‘self-determination’ are the two key concepts. The Australian couple’s actions are portrayed as a clear example of ‘self-determination’: these people carefully arranged their own ‘death with dignity’, once they had decided that their life was ‘completed’. Their life, and given their options, also their death, is the ultimate success story which lacked just one thing: the Australian state should have facilitated their death so that it might have occurred with even more dignity and not in a foreign land. Such arrangements should be available worldwide, is the message voiced explicitly by Athol and Beverley, and implicitly in how their act of self-determination was presented by the Dutch newspaper.
Personally, I find the apparent normalcy of this message in the Dutch political climate, and hence the progressive normalization of suicide, very disquieting. I shall motivate my concerns from a care-ethical perspective, taking the angle of relationality. Before I describe my position further, I first offer a brief sketch of the current Dutch political position with respect to euthanasia and assisted suicide. For an earlier explanation of the proposed ‘completed life act’ I refer the reader to another one of my articles on this website, titled ‘Nine misunderstandings regarding ‘completed life’.
Proponents of a completed life act advocate a change in the approach to assisted suicide for people aged 75 and up. Providing such assistance is currently punishable, in principle, but the Dutch Civil Code does make an exception for medical doctors, conditional on meeting certain conditions (the so-called ‘requirements of due diligence’). These conditions include that the suffering of the person to be assisted must be unbearable and without prospect of improvement. The fundamental worth of human life thus remains the moral touchstone, and as such the Dutch policy remains in step with the international treaties that the Netherlands has ratified. After all, doctors who facilitate assisted suicide are only considered not-punishable in highly exceptional circumstances.
The proponents of a completed life act wish to drastically simplify those circumstances, however. Some even go as far as to argue that people don’t necessarily need to be burdened by suffering to request assisted suicide. If suffering is part of the situation, then it should be clear that the requesting person’s interest is not just an alleviation of that suffering. In the resulting debate, opponents are often characterised as ‘religious and therefore not progressive’.
My opinionated article
In response to the story about the Australian couple and especially how this story was presented, I sent an opinionated article to the NRC newspaper. I did so as a care ethics professional and, deliberately, as a humanist. Below is the (translated) text of my published article.(1) The newspaper chose the title and also performed some edits on my own original text.
Do not disguise suicide as art-of-life
The article ‘Our completed life’ in the weekend edition of NRC Handelsblad, dossier title ‘Self-determination’, left me dismayed and astonished. My dismay is motivated by my humanistic – indeed, non-religious – and care ethical background. I am especially astonished at the way the Australian couple concerned (William Athol Whiston and Beverly Ann) relate to their friends and family.
About their son Carl we read that he was sent to boarding school at the age of 10 because “the life of partying, seeing friends, working hard and lots of moving around” would not suit a young child. As she told a Dutch friend (apparently laughing out loud as she did so), Beverly Ann did not consider herself to be a good mother.
Carl did not receive much warmth during his childhood years, and he continued to find life difficult as a teenager and into his twenties. He had become a loner, although the birth of a daughter had helped him become more open and happier. Still, Carl’s problems did not stop Athol and Beverley from enjoying a “great life”.
As the years pass, the bond between parents and son improves. And at a certain point they tell Carl that they wish to commit suicide together (I leave aside the euphemism of ‘a completed life’). The reason is that Athol is facing the prospect of ending up in a wheelchair and, considering their life as ‘adventurers’, they do not want to experience any such ‘degeneration’.
Carl initially finds it very hard to take. He wonders why they do not want to see their grandchild grow up. But he comes to understand that his parents could not live with physical degeneration, and he supports them in their wish. His parents carry out their plan and die together in a hotel room in Peru after ingesting a lethal substance that is easy to purchase there.
What Carl finds difficult is that he doesn’t know how to tell his young daughter that grandpa and grandma have died. He leaves her in the illusion that they are still travelling, and sometimes it feels like that to him, too. He would have liked to bring his parents’ ashes from Peru to Australia, but that turned out to be prohibitively expensive.
The article also touches on other relationships, such as their friendship with a Dutch couple: an exception to the couple’s determination to let all their relationships with friends and families fade away and to not make any new friends. After all, this would only amount to ‘more people to say goodbye to’.
It apparently did not occur to them that the definitive goodbye might also be difficult for those who remain behind. Or, that it might be very confronting for the hotel staff to chance upon the double suicide by tourists in one of their rooms.
In my view, this story exemplifies a very worrying ethos, or practical morality. A discourse in which such an ethos is presented as an example of successful self-determination and hence of a sophisticated art-of-life seems abhorrent to me. Are people like Athol and Beverley the Heroes of Latter-day Modernity? The reader is greeted by their beaming smiles on the front page. These people are not afraid of death and have the courage to do what every sensible person should want and even ought to do; that, at any rate, is the message I read in the way in which they are presented. This message is reinforced by the added section in which the author of the article, Van Steenbergen, gives answers to seven questions about the notion of a completed life, the current law, and the available substances. In this way the newspaper casually acts as an adviser to people considering the same course of action.
It would be to NRC’s credit to connect the notion of self-determination to a narrative that exemplifies positive freedom (how and for what to live as an autonomous person) and to a relational understanding of autonomy, rather than the autonomist understanding propounded by this article.
Translation: Beter Engels Vertaalbureau
1. Molenaar, B.(2018, 23 mei).Verpak zelfmoord niet als levenskunst. nrc.next & NRC Handelsblad, p. 18-19.