January 26, 2025
Till death do us part: more people opt for Duo Euthanasia
The number of elderly people who want to die at the same time as their loved one is growing.
‘Duo euthanasia’ is seen by some as the height of romance, but is not always manageable.
‘On the day of the euthanasia, they went for coffee and cake first’ report Gertien Koster and Jos Schuring in Het Parool.
British band ‘White Lies’ grow old together and die at the same time’.
As beautiful as that sounds, dying together is given to very few people.
It can be done, though, in the form of duo-euthanasia.
This usually occurs in couples, as was the case just last year with former prime minister Dries van Agt, who died on 5 February hand-in-hand with ‘his girl’, as he called his wife Eugenie.
But this form of euthanasia can also take place in a different kind of relationship; euthanasia has already been granted to a mother and a daughter.
Limburg sisters Miet (89) and Len (79) Sillen were also euthanised together, in January 2024.
Their younger sister Chris Kugler (74) and her daughter Kim (49) had known for four years about this wish to step out of life together.
Kim Kugler:
‘My aunts came from a big family. Miet and Len both never married. They lived together for almost forty years. Len suffered a brain tumour five years ago and later a stroke.
This left her dependent on Miet, who herself struggled with rheumatism, polyarthrosis and severe nerve pain.
When their health deteriorated further, they applied for euthanasia at the same time.’
Many people see duo euthanasia as the epitome of romance and connection, and as an act where two loved ones can die with dignity together.
But it also raises questions about the independence of those involved.
Are they both capable of making an informed decision? Or, on the contrary, are they too connected to each other in their suffering?
After all, the emotional connection could influence decision-making.
And are doctors, who are involved in assessing euthanasia, able to investigate that? Each euthanasia applicant should have a different counsellor, to ensure that their requests are assessed independently.
Gingerbread
Kim Kugler explains that Miet and Len were indeed each visited by their own doctor.
‘There were no obstacles and the agreement followed quickly, after which they could choose a date.
They wanted to die quickly, but still decided to say an extended goodbye to their loved ones first.
They sent an invitation to family and friends and planned all the arrangements in one weekend: four half-day sessions with an hour and a half break in between.
The sisters had a great weekend, but were broken down with fatigue and grief afterwards.’
‘A day or two before the euthanasia, I ran into Miet at the mall where she was doing her last shopping,’ says Kugler.
‘She loved gingerbread and told me she had only bought half a cake, as a whole one would not go up anyway.
On the day of the euthanasia, they first went for coffee and cake, then the sisters sat down in recliners and said to each other: ‘We’ll see each other upstairs.’
They died hand in hand. Since they had made their bodies available to science, we had to wait for hours for them to be collected.
All that time, Miet and Len remained sitting there. We had never witnessed them so quietly for so long.’
Inhuman
Couple Theun and Lidy Kootje stayed in a nursing home in Amsterdam-West in spring 2023. She had been diagnosed with an aggressive brain tumour. She was 81 at the time, he 83.
A week later, he suffered a brain infarct and became semi-paralysed.
Her condition deteriorated so quickly that she requested euthanasia three weeks after the diagnosis – she was given permission.
He also wanted to die, but his request ran into problems because his health was still too good, so he withdrew it. She died four days after she made the request.
The Kootje couple had had an ideal marriage and a wonderful life, Theun Kootje says.
Both were devastated with grief: Theun found the idea of having to go on without his wife ‘unbearable suffering’.
She felt it was inhumane that her husband was not allowed to accompany her into death.
Now, a year and a half later, Theun looks back on it differently: ‘I can manage myself and things are going reasonably well, but if my life ends tomorrow, it’s fine too.’
He does now understand the refusal of his request. ‘At the time, I didn’t. But in retrospect, I understand that I was just too healthy for euthanasia.’
There are also people who take matters into their own hands, such as the sister and his husband of Amsterdam resident Erik van Erp (81): ‘They had been members of Coöperatie Laatste Wil (CLW) for years.
This is an organisation that fights for people to make their own choice to end their lives in a humane way and at a time of their own choosing, without being dependent on a doctor.’
‘Mien, my sister, and her husband Frits were in their eighties.
They told me in October 2021 that they had Middel X in the house. This consists of a combination of a number of toxic substances and was seen as a means of suicide in a humane way, for people who feel their lives are complete.
Once you ingest it, there is no antidote or medicine to undo the effect.’
Stomping with anger
They told Van Erp that they had purchased the drug years ago.
‘My sister was going through some dementia and was suffering from pain in her thigh,’ Van Erp said. ‘Her husband was healthy, just a bit deaf.
A consultant from the CLW told them: ‘Middel X is fine, you may get some side effects but you are guaranteed to be dead within half an hour.’
Then they got a bit nervous anyway and went to the GP to ask her for euthanasia.’
Earlier, they had not discussed it with the GP.
‘Mien was then pushed into a medical circuit that she didn’t feel like doing at all.
The GP called in a geriatric consultant. The latter didn’t want Mien to die and thought she should go to a home.
‘I don’t want that, I want to die,’ my sister said. I can still picture her like that, stomping with anger.
They were not depressed, my sister maybe a little, but her husband certainly not. All in all, that medical circuit lasted a year. ‘
Frits then ordered the drug ‘nembutal’ abroad. ‘Because of its use for suicide, it was taken off the market in the Netherlands in the 1980s.
Frits carefully directed their end of life.
He sent himself a letter on Saturday to see when it would be delivered. That turned out to be on Tuesday.
Then two weeks later, Mien and Frits sent quite a few letters on Saturdays, including to the GP.
In that envelope they had put the key to their home and a short note.’
The GP then found them hand-in-hand. ‘Along with the police, whom she had called and who arrived with screaming sirens.
They were lying there peacefully, according to the GP. She later apologised to us, the bereaved family, for not listening properly to Mien and Frits.
Fortunately, I was able to say goodbye properly when I knew it was almost here. I received a photo in the mail on that particular Tuesday with the text: ‘We had a beautiful life’.
At the memorial service, I told them how their life ended. I think they did well.’
33 Duos
The Dutch euthanasia law has been in place for more than 20 years. Every year 170,000 people die in the Netherlands, 9,000 of them through euthanasia.
If two people are euthanised together, an euthanasia review committee registers this as duo euthanasia.
In 2018, it happened 6 times; in 2023, it happened 33 times.
This means that 66 notifications were made in the latter year, because due diligence criteria must be met with each person separately. How many applications from duos are rejected is not known: that is not kept up to date.
So the number of times duo-euthanasia is committed is rising, but -according to Amsterdam GP Marike de Meij, who is also a member of the regional euthanasia review committee, relatively few people are involved.
Exit Note: a ‘Double Sarco’ is currently in design and should be completed by the end of 2025.
It’s use in the Netherlands remains prohibited.
