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Death Wishes of the Elderly: Is There a Task for Doctors?

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Ethics, Health Policy and (Anti-) Aging: Mixed Blessings

Part of the book series: Ethics and Health Policy ((EHP,volume 1))

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Abstract

Mr. Kalisvaart is almost 90 years old. He has been a very independent and active man all his life. Since 15 years he suffers from glaucoma in both his eyes, and by now he is almost completely blind. His hearing has also much declined in recent years. He is therefore unable to listen to classical music which used to be his passion. Moreover, as a result of disc degeneration he has serious back pain.

*Thanks to Boudewijn Chabot, Mette Rurup, Dorothea Touwen and Henri Wijsbek for helpful comments and/or suggestions.

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Notes

  1. 1.

    Ecclesiasticus 41: 3, King James’ translation, cf. one of Brahms’ Vier ernste Lieder.

  2. 2.

    An interesting result of this study is that doctors sometimes do not recognize a request as such because they don’t consider it really intelligible in the circumstances. This should make us wonder whether the assessment of the competence of the requester and the evaluation of his request can be as independent of each other as the dominant view of competence in medical ethics holds.

  3. 3.

    For an authoritative overview of the present Dutch law and practice see Griffiths et al. 2008.

  4. 4.

    HR 24/12/2002, NJ 2003/167; Tijdschrift voor Gezondheidsrecht 2003/29

  5. 5.

    Jaarverslag (Annual Report) regionale Toetsingscommissies Euthanasie 2009, case 9.

  6. 6.

    The Society has changed its position, however, in a position statement of November 12 2010, in recognition of the case law of the review committees.

  7. 7.

    Cf. http://vorige.nrc.nl/international/Features/article2478619.ece/Citizens_group_argues_right_to_die. In March 2012 Parliament decided not to take over the Initiative at the moment, but to reconsider the matter in the context of the evaluation of the euthanasia law, which is scheduled for the end of 2012.

  8. 8.

    A classical source is Dworkin et al. 1997.

  9. 9.

    I have argued for this interpretation in den Hartogh 2012. The interpretation is confirmed by the travaux préparatoires of the euthanasia law and the parliamentary debate, as analysed by Pans 2006.

  10. 10.

    Affaire Haas c. Suisse, 20 janvier 2011, Requête no 31322/07, cf. den Hartogh 2011.

  11. 11.

    Chabot-case, HR 21/6/1994, NJ 1994, nr. 656, translated in: Griffiths et al. 1998, 329–340.

  12. 12.

    Rurup et al. 2010 found a significant number of people with death wishes to have speech impairments.

  13. 13.

    Some descriptions of the syndrome focus on functional disabilities (Rockwood et al. 2000), others include diseases. Some descriptions are restricted to physiological conditions (Fried et al. 2001), but there is no reason not to include psychological conditions as for example mood disorders or loss of cognitive abilities, Gobbens et al. 2010.

  14. 14.

    Van der Wal et al. 2003, p. 51. Jaarverslag regionale Toetsingscommissies Euthanasie 2009, p. 20, cf. case 7.

  15. 15.

    And to Edwards 2003.

  16. 16.

    That suffering is intersubjectively accessible in this way is stressed by Wijsbek 2012. He also refers to research by Patrick Wall a.o. showing that the phenomenological and the interpretative component are mutually dependent on each other: soldiers wounded at the battlefront feel less pain when they know they will now be allowed to return home.

  17. 17.

    The Belgian law requires “a serious and incurable ailment caused by accident or illness”.

  18. 18.

    According to Rurup 2005, Chap. 2, see note 7, 1 of the 6 cases in which a doctor refuses a request concerns a tired-of-life case. According to Chabot (personal communication) this is true of 27 % of the cases identified in Chabot 2007 in which no “severe illness” existed and in which the doctor refused a request.

  19. 19.

    On reasons for refusal see Pasman et al; Chabot 2007, 128; and in particular Van de Vathorst et al. 2011.

  20. 20.

    See also Jansen-van der Weide et al. 2005; Pasman et al. 2009; Van de Vathorst et al. 2011, Chap. 9.

  21. 21.

    Because of its reliance on such statistics most present research on suicide gives a false picture of the phenomenon, Chabot 2007.

  22. 22.

    See note 17.

  23. 23.

    It is, however, an urgent task for governments to reconsider the doctor’s monopoly on the prescription of deadly drugs. Either the inaccessibility of such drugs to others should be enforced, if it is still possible to do that, or the monopoly should be lifted. Otherwise the law will quickly become a dead letter.

  24. 24.

    Quoted from Birnbacher 2010.

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  1. University of Amsterdam, Binnenstad, The Netherlands

    Govert den Hartogh

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    Wim Pinxten

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den Hartogh, G. (2013). Death Wishes of the Elderly: Is There a Task for Doctors?. In: Schermer, M., Pinxten, W. (eds) Ethics, Health Policy and (Anti-) Aging: Mixed Blessings. Ethics and Health Policy, vol 1. Springer, Dordrecht. https://doi.org/10.1007/978-94-007-3870-6_10

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