Euthanasia: Why members of a happily married couple decide to die together

Three days before they voluntarily took their last breath, John and Else’s caravan pulled up at a sunny marina in Friesland, north of the Netherlands.

They were a couple who loved to travel and lived in an RV or boat for most of their marriage.

“Sometimes we try [vivir] In a house,” John joked when I met them, but it didn’t work.

At 70, he sat on one of his legs in the truck’s swivel driver’s seat: it relieved his persistent back pain. His wife, Else, was 71 and suffered from dementia. By the time I met them, he was already having trouble forming his sentences.

“This,” he said, rising easily from his seat, and pointing to his body, “but this,” he said, pointing to his head, “is terrible.”

John and Else met in kindergarten and their relationship lasted a lifetime.

As a teenager, John played hockey for the Netherlands national youth team and later became a sports coach. Ells trained as a primary school teacher. But it was their shared love of the water, boats and sailing that defined their years together.

When they were a young couple they lived on a boat. They then bought a cargo ship and built a business transporting goods on the inland waterways of the Netherlands.

Meanwhile, Else gave birth to her only child (she asked not to be identified). He attended a residential boarding school during the week but spent weekends with his parents. During the school holidays, when their son was also on board, John and Else looked for work trips that would take them to interesting places along the Rhine or to the islands of the Netherlands.

By 1999, the trucking business had become more competitive. John suffered from severe back pain due to his hard work for more than a decade.

He and Else moved to the mainland, but after a few years they returned to live on a boat. When that became too much to handle, they bought their spacious motor home.

John had back surgery in 2003, but there was no improvement. She was off a strict regimen of painkillers and could no longer work, but Els kept busy teaching. Sometimes they talked about euthanasia: John explained to his family that he did not want to live much longer with his physical limitations. It was around this time that the couple joined NVVE, the Dutch “right to die” organization.

“If you take too many drugs, you live like a zombie” John told me, “The pain I have and Else’s illness, we have to stop this.”

When John says “stop this,” he means “stop living.”

In 2018, Ells retired from teaching. He began to show early signs of dementia but was reluctant to see a doctor, perhaps because he had witnessed the deterioration Alzheimer’s had caused his father and his subsequent death. But there came a point when his symptoms could not be ignored.

In November 2022, after being diagnosed with dementia, Ells left the doctor’s office, leaving her husband and son behind.

“I was as angry as a bull,” John recalls.

After Else learns that her condition is not improving, she, John, and her son begin to talk about euthanasia as a couple: the two will die together.

In the Netherlands, euthanasia and assisted suicide are legal, and if someone voluntarily requests it, doctors must diagnose their suffering. -Physical or psychological- “unbearable”, no opportunities for improvement.

Each person requesting assisted dying is assessed by two doctors, the second verifying the assessment carried out by the first.

In 2023, 9,068 people died by euthanasia in the Netherlands, 5% of all deaths. There were 33 cases of euthanasia in one pair, i.e. 66 people. These are complex cases that can open the door to uncertainty about their ability to give consent if one of the couple has dementia..

“Many doctors don’t even want to think about euthanizing a dementia patient,” says Dr. Rosemarijn van Brussem.

This is the case with John and Else’s GP. This reluctance among physicians is reflected in euthanasia statistics. Of the thousands who died in 2023, just 336 had dementia. How do clinicians assess the legal requirement of “intolerable suffering” for dementia patients?

For many people with early stage dementia, Uncertainty about how things might progress This can lead them to think about ending their lives, explains Dr van Brussem.

“Can’t I do the things I think are important? Will I no longer recognize my family? If it is sufficiently expressed, it will be visible to both the physician who is willing to perform euthanasia. [segundo] A doctor specializing in mental capacity may consider the existential fear of what is going to happen as a reason to consider euthanasia.

When their family doctor is uncooperative, John and Else go to a mobile euthanasia clinic.: Center for Euthanasia Specialists. This revolutionary model oversaw 15% of assisted deaths in the Netherlands last year and, on average, provides a third of the requests it receives.

In the case of couples who wish to end their lives, clinicians must ensure that one partner is not influencing the other.

Dr. Bert Kaiser has treated two cases of couple euthanasia. He also recalled that he met another couple who suspected that the man was coercing his wife. On another visit, Kaiser spoke with the woman alone.

“He said he had many plans…!” Kaiser says that the woman clearly felt that her husband was seriously ill, but I have no plans to die with him.

The euthanasia process was stopped and the man died of natural causes. His wife is still alive.

Dr. Theo Boer, professor of health ethics at the Protestant Theological University, is one of the most outspoken critics of euthanasia in the Netherlands and believes that advances in palliative care have reduced the need for its use more often.

“I would say that killing at the hands of a doctor can be justified. However, this should be an exception.

The impact of couple euthanasia cases worries Dr Boyer, particularly after the former Dutch prime minister and his wife decided to die together earlier this year. and made headlines around the world.

“We saw dozens of paired euthanasia cases last year, and there is a general tendency to ‘heroize’ the death together,” says Dr. Boyer. “But the ban on intentional killing is being eroded, especially when it comes to double euthanasia.”

The day before her meeting with the doctors responsible for the euthanasia, Else, John, her son and her grandchildren were together. John, ever practical, wanted to explain the specifications of the motorhome so it was ready for sale.

“Then I went for a walk on the beach with my mother,” says his son. “The kids were playing, there were some jokes… it was a very strange day.

“I remember we had dinner and I got teary-eyed watching us have dinner together.”

On Monday morning, everyone gathered at the local hospital. Her son was accompanied by the couple’s best friends, John and Else’s brothers and their daughter-in-law.

“We were together for two hours before the doctors came,” she says. “We talk about our memories … and we listen to music.”

just From Travis to Else, and Now and then The Beatles’ Jan.

“The last half hour was tough,” says his son. “The doctors came and everything happened quickly: they followed their routine and then it was only a few minutes.”

Else von Leiningen and John Faber were given lethal drugs by doctors and they died together on June 3, 2024.

Your motor home has not yet been put up for sale. Else and John’s son has decided to put it away for a while and go on vacation with his wife and kids.

“Eventually I’ll sell it,” he says. “I want to make some memories for the family first.”

This story is an adaptation of the BBC documentary “Loving, Living and Dying Together”, which you can watch in its entirety and in its original language. Here.