January 8, 2025
Why do we find it so difficult to talk about voluntary death in the Netherlands?
Opinion by Melvin Keijzer
Even in a progressive city like Amsterdam, talking about death is a taboo, argues Melvin Keijzer – and about voluntary dying altogether.
He argues for an open debate on self-determination. ‘Only that can reveal where the limits of autonomy should lie.’
Recently, a woman (64) in Switzerland ended her life in the Sarco, a suicide capsule designed by a Netherlands-based doctor.
But in the Netherlands, including a progressive city like Amsterdam, open discussion about voluntary death is still very difficult.
Why can’t we in the Netherlands embrace the same openness around death? Why don’t we recognise that death, like life, is part of personal autonomy?
Why is the control still in the hands of others?
The statements of euthanasia doctor and philosopher Bert Keizer in the weekend edition of Het Parool are a striking example. While he favours a completed-life remedy, he continues to think ‘conditionally’.
So as promising as his words sound, ultimately a doctor or some other institution will decide.
Recall that our existence has never been a choice of our own: we are here because others once chose it. Soit. But then, may the freedom to decide when our life ends be granted to ourselves? Voluntary death may come only at a completed life, but what is that?
Does completed life have a timeline? And either way, death will come.
Dying is just falling asleep, as Bert Keizer also relativises in his interview. So what is the problem?
Right to self-determination suits Amsterdam just right
In Amsterdam, a city known for its tolerance and free spirit, talking about death remains a taboo.
As a 30-year-old Amsterdammer, I notice that talking about death causes discomfort within my circle of friends and my own generation.
When I say that I don’t mind dying per se, the question quickly follows, ‘Are you OK?’
It seems as if thinking about mortality is something you are only allowed to do when you are old – or incurably ill.
Amsterdam has a history where personal autonomy and the right to self-determination were already central.
The Provos of the 1960s, with their idealistic actions, fought for more freedom and self-determination in the lives of ordinary Amsterdammers.
Their struggle raises the same core question: how do we give individuals control over their own existence, even to the end?
While studying law, I organised a symposium on self-determination.
Albert Heringa, a former biologist, told how he helped his mother (99) die because no doctor was willing to grant euthanasia. Heringa was prosecuted for assisted suicide and initially sentenced to six months’ suspended imprisonment.
The European Court of Human Rights ruled that the Netherlands did not violate human rights by prosecuting him.
However, the law did violate Heringa’s mother’s personal autonomy at the time. Why should someone who consciously chooses a dignified end not be helped humanely?
Radical expression of freedom
‘To learn philosophy is to learn to die,’ wrote Michel de Montaigne back in the 16th century. At the very least, a call to reflect on our mortality. In the Netherlands, this philosophical openness clashes with a paternalistic urge to regulate.
In current euthanasia legislation, medical suffering is central, leaving the choice of voluntary, self-determined dying almost entirely in the hands of doctors.
‘We live in an age where we consider control over our lives increasingly important – but that control strangely stops at the end of life’
The choice to die is perhaps the most radical expression of freedom and personal choice.
Yet we seem to prefer to outsource that responsibility to rules, institutions and medical professionals. The question remains whether this does not unnecessarily restrict the autonomy of the dying person, when that person consciously chooses a humane end.
This keeps the social taboo alive
Recently, a conviction was pronounced in the Netherlands for providing a so-called humane suicide drug (‘drug X’).
The reasoning is that this not only endangers public health, but also that inciting and facilitating suicide should remain punishable outside the legal framework.
This raises the question of whether the wrong signal is being sent: instead of creating space for an open conversation about self-determination and the possibility of a voluntary end of life, criminal law remains the main way to dissuade people outside the medical realm from such a decision.
Thus, the social taboo remains intact. Only an open, public debate can reveal where the limits of autonomy should lie.
The Sarco capsule, however controversial, represents more than a technical tool. Sarco represents a new way of thinking about autonomy and dignity. Not to romanticise death, but to see it as an integral part of being human.
We live in an age where we consider control over our lives increasingly important – but that control strangely stops at the end of life.
If we are not free to choose when our lives end, what is left of our freedom? It is time to bring death out of the shadows.
Melvin Keijzer studied law, is an entrepreneur and lives in Amsterdam.
