A doubleplusungood story about Dutch euthanasia

The death of a 17-year-old girl suffering from anorexia raises serious questions

By Michael Cook

Last week the news that Noa Pothoven, a 17-year-old Dutch girl suffering from anorexia nervosa, had been euthanised flew around the world.

It wasn’t true.

The Royal Dutch Medical Association (KNMG) clarified what had really happened: “She decided to stop eating and drinking to bring her own death. In The Netherlands, this is not considered euthanasia or physician assisted suicide.”

Chastened, the media issued corrections and moved on. Admittedly, sloppy reporting was involved. It turned out that Noa had asked for euthanasia at the Levenseinde Clinic in The Hague — a Dutch end of life clinic which specialises in “patients whose requests for assisted dying are more complex and often denied by their own physician”. Its doctors refused. “It would be fake news if we made this euthanasia,” the clinic’s director, Steven Pleiter, told the New York Times.

From a public relations point of view, supporters of Dutch euthanasia retired victorious from the field of battle. The original reports in the English-language media made it appear that euthanasia is freely available in the Netherlands, even for minors, and even for psychiatric reasons — and this is not completely true.

“There is a lot of misunderstanding about our legislation around euthanasia,” Dyck Bosscher, of the Dutch Voluntary Termination of Life Association (NVVE), told CNN. “The media reports make it seem as if it is easy to get euthanasia in the Netherlands, but it’s not the truth.”

Indeed, practitioners of euthanasia in the Netherlands emerged from the publicity given to Noa’s death looking sober, judicious, prudent, and compassionate.

But is this deserved? Not at all.

First of all, we don’t have all the facts to know whether her doctors made the right decision in assisting her death by starvation.

Noa said that she had been being sexually abused at age 11 and raped at 14. Sadly, this could easily have been true. Sexual abuse is known to trigger anorexia. But the media failed to query the truth of her story, out of respect, perhaps, and to avoid giving her pain. She had even concealed the abuse from her family and to the end could not bear to discuss the crimes which made her hate her own body.

But without that back story, would her family, her doctors and the media have affirmed her decision to starve herself to death? Readers were left with the impression that starving oneself is a rational, medically-justified option to being a victim of rape. It’s more likely that her psychiatrists were not competent enough to treat her. Tragically, it became a case of punishing the victim for the crimes of her abusers.

Second, the ghoulish interest of the Dutch media in Noa’s plight must have strengthened her resolve to end her life. She published an autobiography Winnen of Leren (Winning or Learning) last year and was awarded a 1000 Euro prize for it. She was interviewed on television about her thwarted desire for euthanasia. She became a celebrity because she wanted to die – and because she was a celebrity, she had to die.

It was like crowds howling “jump! jump!” to a frightened girl clinging to a bridge.

This kind of journalism almost certainly breaches the guidelines issued by the World Health Organization for media reporting about suicide.

Third, the KNMG’s objection that stopping eating and drinking under medical supervision is not physician-assisted suicide is an example of 1984 Newspeak. Starvation as an alternative to assisted suicide is so well-known in the medical literature [http://www.annfammed.org/content/13/5/408.full ]that it has its own acronym, VSED(voluntary stopping of eating and drinking). Compassion and Choices, the leading American right-to-die organisation, advertises it as an alternative to physician-assisted suicide.

Noa Pothoven committed suicide and, as her parents have acknowledged, she was assisted by physicians. The KNMG’s indignation is straight out of Through the Looking Glass. As Humpty Dumpty said, “When I use a word, it means just what I choose it to mean—neither more nor less.”

If Noa’s death wasn’t physician-assisted suicide, then I’m a Dutchman.

Unfortunately, the Dutch have become hardened to doublespeak about euthanasia. Apart from VSED, another “unofficial” type of assisted suicide of euthanasia is terminal, or palliative, sedation. Here’s what The Guardian reported earlier this year:

As people got used to the new law, the number of Dutch people being euthanised began to rise sharply, from under 2,000 in 2007 to almost 6,600 in 2017 … the number of people who died under palliative sedation – in theory, succumbing to their illness while cocooned from physical discomfort, but in practice often dying of dehydration while unconscious – hit an astonishing 32,000. Altogether, well over a quarter of all deaths in 2017 in the Netherlands were induced.

But none of those 32,000 were euthanasia either, according to the KNMG’s criteria.

Isn’t the real news here something altogether different from the KNMG’s sanitised narrative of a sad-but-unavoidable death? Dutch doctors who were unable or unwilling to treat a 17-year-old rape victim for anorexia nervosa gave up on her and allowed her to kill herself.

In her time of greatest need, they abandoned their patient.

Michael Cook is editor of MercatorNet where this appeared. Reposted with permission.