Slides available here
Els talked about the work she did for her PhD in which she studied 25 people aged over 70, who felt that their life was complete and no longer worth living, despite not having severe medical conditions. These people were not eligible for euthanasia under the current law in the Netherlands, but could be eligible under proposed changes to the law which are currently under discussion. Her work developed both an in depth understanding of the phenomena, and investigated what it means to live between intending to end one’s life and actually doing so.
She identified a number of common threads experienced by these people: aching loneliness; not mattering; inability to express their identity; multidimensional tiredness; and aversion towards feared dependence (such as needing to move to a care home). The people felt that their personality was dependent on them being able to do something that mattered, feeling connected, and being independent. But they had reached the stage when they realised that this was no longer possible. As a result they felt that death was the only way out and they were considering means of bringing this about.
While understanding the underlying reasons for people wishing to end their life, Els suggested that caution was necessary in any legislation which permitted medical assistance for such people. In particular she highlighted the difficulties of safely establishing the consistency over time of the person’s decision; of ensuring there was no external pressure in reaching the decision and of establishing that non-medical suffering was insoluble – for example by offering better social support.