Euthanasia in a Minor Key

The Tragic Tale of a Young Girl's Demise

On June 3, 2019, the troubling story of the death of 17-year-old Dutch girl Noa Pothoven went viral, with initial reports claiming she had been voluntarily euthanized. Within a day, those claims were proved false. Noa committed suicide by refusing to eat or drink. Since the medical community and her parents declined to force-feed her, her death is referred to as "passive euthanasia."

"Euthanasia" is the direct killing by doctors of their patients. "Assisted suicide" is the indirect killing of patients by doctors who provide the means by which patients can commit suicide. The circumstances surrounding Noa's death expose the anti-life nature of the Dutch euthanasia policies and the implications of radical autonomy.

Pothoven had suffered from depression, anorexia, and post-traumatic stress disorder and had attempted suicide multiple times as a result of being sexually assaulted at age 11, assaulted again at age 12, and raped by two men at age 14. She did not tell anyone of these experiences for a long time because of her feelings of "fear and shame."¹

In an article appearing in the Dutch newspaper de Gelderlander in December 2018, six months prior to her death, Noa's mother disclosed that,

For the sake of her safety, Noa has been admitted to three youth care institutions in recent years, but she should actually be admitted to a closed institution for youth psychiatry. There are also huge waiting lists there. We actually want one place for her, where she can stay and where all her physical and mental problems are addressed. You can't find it in the Netherlands. ²

Noa herself added,

That's crazy. . . . If you have a serious heart disease, you can undergo surgery within a few weeks. But if you become acutely mentally ill, then they say casually: unfortunately, we are full, just go on the waiting list. And you have to know that one in ten anorexia patients in the Netherlands dies from the consequences of the eating disorder.

Those don't sound like the words of a girl who wanted to die. They sound like the words of a girl whose hopes for help had been thwarted and were understandably dimming.

Where's the Autonomy?

In the Netherlands, children as young as 12 years old can be actively euthanized with parental consent, and 16–18-year-olds can be actively euthanized with parental knowledge but without parental consent. While euthanasia debates in the United States focus on those with terminal illnesses, both the Netherlands and Belgium—where there are no age limits on euthanasia—will euthanize those who suffer from mental illness.³ The New York Times reports that "of the 727 patients who were euthanized [thousands more were "assisted" in their deaths] last year, about 50 were patients with mental health problems."

The well-known End of Life Clinic (Levenseindekliniek), which "offers euthanasia or assisted suicide to people whose request for assisted dying was first denied by their own physician,"⁴ reports that just days after news of Noa's death went viral, they received a dramatic increase in euthanasia requests: "Usually we get one or two requests per week from abroad about euthanasia. . . . Yesterday (Thursday) there were 25."⁵

The clinic's website explains the criteria used to determine whether euthanasia or assisted suicide is legally permissible:

In the Netherlands doctors may provide assisted dying if the patient makes a clear and autonomous request and is enduring unbearable and unendurable suffering, if no other reasonable solution is foreseeable, and if the patient realizes the consequences of what they are requesting.⁶

Can a teenager suffering from depression, PTSD, and anorexia so severe her organs once shut down possibly understand the consequences of such a request? Can a young person so severely traumatized possibly see the future with any clarity? How much weight was given to the "autonomous" part of those criteria, as opposed to the clarity of foresight and capacity to fully realize the consequences of suicide?

Despair Is Spreading

Pothoven wrote an award-winning book, Winning and Learning, about her struggles, in which, according to de Gelderlander, "She hopes for 'a miracle,' but she thinks it is probably hope against knowing better. If that also fails, then life has nothing to offer her." Evidently that despair is spreading. Reuters reported that "there is an ongoing debate about widening the criteria to allow elderly people who feel their life has been 'completed' to seek euthanasia. Polls last year showed 62 percent of Dutch people support a law making that possible, with strong opposition from Christian parties."⁷

We don't know what Noa's worldview was, but we do know that the Netherlands is not a place known for robust Christian communities.8 And we know that worldviews that include no grand meta-narrative, no valuation of suffering, no vision of an afterlife, and no conception of human worth as objectively and transcendently established by God offer little solace, hope, or justification for enduring the suffering that comes in lesser and greater measure to every human born into this fallen world.

Notes
1. nytimes.com/2019/06/06/world/europe/noa-pothoven-instagram-euthanasia.html.
2. gelderlander.nl/home/noa-16-uit-arnhem-is-nu-al-klaar-met-haar-verwoeste-leven~a01a7bd1.
3. statnews.com/2017/10/26/euthanasia-mental-illness.
4. levenseindekliniek.nl/en.
5. thejakartapost.com/news/2019/06/08/dutch-clinic-sees-jump-in-foreign-euthanasia-requests-after-teens-death.html.
6. levenseindekliniek.nl/en/euthanasia-in-the-netherlands.
7. reuters.com/article/us-netherlands-suicide/after-teens-death-dutch-investigate-group-promoting-suicide-powder-idUSKBN1GX2JV.
8. https://nos.nl/artikel/2092498-hoe-god-bijna-verdween-uit-nederland.html.