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“What was ‘unthinkable,’ in hindsight, was perhaps inevitable”: the dynamics of euthanasia laws

by | Apr 14, 2016

By Paul Russell, Founder, HOPE Australia

Editor’s note. The following is excerpted from a post that appeared at noeuthanasia.org.au.

Prof. Theo Boer

Prof. Theo Boer

In a recent interview for a Portuguese television network, Dutch Professor Theo Boer gave, for me, the clearest explanation yet of the situation in both Belgium and The Netherlands.

The interview opens with Boer giving an overview:

“For a considerable number of people, euthanasia has become part of their lifestyle; it has to do with controlling your destiny. In the beginning euthanasia was seen as a last resort in a situation of extreme physical suffering. Now, increasingly, euthanasia is considered to be a patient’s right and is considered by some even to be a fashionable death.”

This from a man who not only once supported the Dutch euthanasia laws and who, for many years until 2014, was also a member of one of the Dutch Regional Euthanasia Evaluation Committees overseeing the practice of the law.

“I was also relieved that I could quit because, in the last couple of years (I quit in 2014) I had considerable problems with my conscience because I saw that people were being euthanized in cases where, in my opinion, it was not necessary.”

Earlier in the interview Boer laid out some of his observations:

“Not only the numbers have gone up considerably but also the reasons why people want to have euthanasia. For example: two people – lovers – where one person dies of cancer, the other person (who is care dependent) also wants to die. Or people who have autism; people who have blindness, or people who have dementia, or psychiatric problems – those were unthinkable in the beginning.”

Boer summarises:

“Once a law has been established it will create its own demand, it will create its own dynamics; which means that, in The Netherlands, at this moment, there is still an enormous pressure to liberalise further. For example: to have euthanasia for old people over 70 who want to have their lives ended.”

Juxtaposed to Professor Boer in the documentary is Dr. Marc Van Hoey; a Belgian doctor and leading euthanasia activist.

The vision is taken from the documentary by the Australian SBS network, Allow Me to Die first screened in September 2015 where, amongst other stories, we see Van Hoey assisting in the death of an 85-year-old woman via assisted suicide.

Simona de Moor was physically well and on no medication but was grieving at the unexpected death of her favourite daughter only months previous.

As Van Hoey himself acknowledges, the de Moor case has been referred by the Belgian Euthanasia Evaluation Commission to the judiciary for further possible action against him. This is the first such referral since the law came into effect in 2002. The first in something like 8,000 reported deaths.

Van Hoey discusses his treatment of Simona de Moor with SBS journalist, Brett Mason (note: this is prior to de Moor’s death):

Van Hoey: “I started with the medication; with the treatment. She took it for a few weeks or months; but here request (for euthanasia) is still going on. So, she doesn’t want to die because she is depressed, no. She wants to die because she has had it. See the difference?”

Brett Mason: “In medical terms what is the official cause of Simona’s unbearable suffering?”

Van Hoey: “Reactive depression, certainly.”

Mason: “As a result of her daughter’s death?”

Van Hoey: “Yes, and I will mark that on her death certificate, it’s a natural death; euthanasia IS a natural death. And then the second step will be, untreatable depression; the next line will be the death of her only daughter.”

Van Hoey is playing games with Mason and with the audience. He responds instantly and even keenly to Mason’s question about de Moor’s unbearable suffering saying defining it as arising from, ‘reactive depression.’

Reactive Depression is described as: ‘a subtype of clinical depression or major depressive disorder. It is also sometimes called an adjustment disorder with depressed mood, and is characterized by a depressed state in direct response to an external event. The subsequent depression tends to be mild to moderate, and typically will not persist beyond several months after the stressful event.’

Psyweb adds that stressful events can include, ‘everything from the death of a family member, loss of a job, children moving out, or any of life’s other constantly shifting events. These are distinct from grief events, although certain stressors, like the loss of a loved one, will overlap.’

Symptoms can be, ‘characterized by feelings of hopelessness, worthlessness, and sadness. Additional symptoms might include anxiety, weight fluctuations and eating disorders, irritability, memory problems and difficulty concentrating. In extreme cases, it may be accompanied by somatic symptoms like pain, headaches, and digestive problems. Serious warning signs include drug and alcohol abuse, and suicidal thoughts or behaviours.’

A significant problem, clearly, but as this descriptor and every other I read online makes abundantly clear such depression, typically will not persist beyond several months after the stressful event; in this case, the death of de Moor’s daughter.

Even if de Moor’s reactive depression was severe and persistent there were clearly other options available such as continuing treatment and seeking a reconciliation for de Moor with her other, estranged daughter. And, given the diagnosis, there should have been every reason to expect that this fit and capable 85-year-old lady would have made a full recovery. …

Although, with the broad acceptance of doctors killing patients in Belgium and The Netherlands to the point where, as Professor Boer suggests, it is now seen as a ‘right’, it may well be that citizens in those places are becoming so blasé about such practices that what becomes common becomes, perversely, natural.

Regardless, Van Hoey does seem to be in a little hot water over Simona de Moor’s death. The Belgian euthanasia establishment has been growing increasingly annoyed at the negative attention of the international media in recent years.

The referral to justice of the de Moor case by the Belgian Euthanasia Evaluation Commission seems to be a response to this negative media and unwelcome scrutiny. It is certainly not about the commission considering that her death was outside the law. There have been many other deaths over the past few years that, if that were the case, should have been referred in a similar manner.

Whether making Van Hoey an example in the face of exposure by the Australian SBS Network is or is not the primary consideration, Van Hoey’s strongest criticism, it seems, was that he did not conduct the euthanasia ‘carefully’. He did not get an additional opinion as required by the law where the illness or condition is not terminal. …

So, why are the Belgian’s so concerned with being ‘careful’? Simple: doing it ‘carefully’ provides immunity from prosecution for the doctor. Whether the person could have benefitted from further treatment of any kind and whether or not they were suffering from a depression, is not really considered. …

When people think of euthanasia, more often than not they will be imagining that the law is for some very hard case, where the person has tried every remedy and where desperation drives them to ask to be killed. Even if that was how people thought in Belgium and The Netherlands when the law was debated nearly 15 years ago, it is clearly now not the case.

What was ‘unthinkable,’ in hindsight, was perhaps inevitable.

Categories: Euthanasia