What's behind rise in duo euthanasia?

The former Dutch prime minister Dries van Agt died by euthanasia last week, hand in hand with his wife Eugenie. They were both 93.

Both had been in "fragile health" for some time after Van Agt suffered a brain haemorrhage in 2019, said the Daily Mail, and they decided it was better to "pass together given their advanced age and declining physical state".

Their deaths are seen as part of "growing trend" in the Netherlands for "duo euthanasia", said The Observer. The Mail described such endings as "the saddest deaths of all", but how many couples have taken this step and what are the regulations?

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'Fly away together'

The Netherlands, Belgium and Luxembourg are the only countries in the EU where the practice of assisted dying is legal. Euthanasia is illegal throughout the UK and can be prosecuted as murder or manslaughter. But the Isle of Man could become the first part of Britain to legalise assisted dying.

There are reported cases of couple euthanasia as far back as 2003, when a British couple, Robert and Jennifer Stokes, neither of whom was known to have a terminal illness, died at a Swiss euthanasia clinic, said The Guardian. Although the couple had made funeral arrangements before leaving England, they had not mentioned their plans to other family members.

In 2018, George and Shirley Brickenden became one of a rare number of couples in Canada to receive "doctor-assisted death", said The Globe and Mail. The couple said they had welcomed this as an opportunity to "fly away" together.

Both of them had suffered a series of illnesses in their latter years but they had talked about assisted death as an option for nearly 40 years. They became more attracted to it after watching another elderly relative suffer in the last years of her life.

The first official record of couples choosing to take their lives together in the Netherlands was in a review of all cases in 2020, when 26 people were granted euthanasia at the same time as their partners. The numbers steadily rose in the following years: 32 in 2021 and 58 in 2022.

Although no research has been undertaken on why joint euthanasia is rising, there is a simultaneous rise in euthanasia in general, which some experts have argued reflects a more individualistic and less conservative society.

Bypassing grief

Doctors in the Netherlands treat euthanasia requests from couples as two separate applications, each of which go through the same process. "Both partners are interviewed separately," said Dutch News, so the experts assessing the request "can be sure the decision is voluntary".

Often, two doctors are involved in carrying out the euthanasia, so that the couple both die at the same time.

Interest in duo euthanasia is "growing" but "still rare", Elke Swart, a spokesperson for  Expertisecentrum Euthanasie, which grants the euthanasia wish of about 1,000 people a year in the Netherlands, told The Observer.

"It is pure chance that two people are suffering unbearably with no prospect of relief at the same time… and that they both wish for euthanasia," she said.

But the trend has caused concern among some campaigners. Commenting on joint euthanasia, Professor Kevin Yuill, chief executive of Humanists Against Assisted Suicide and Euthanasia, told The Times last year that it is "increasingly seen as a solution for social rather than medical problems", because it is "very unlikely" that couples' medical pathologies "matched so perfectly".

Fransien van ter Beek, who chairs the NVVE pro-euthanasia foundation, said that although many people express an interest in a joint euthanasia, "it does not happen very often because it is not an easy path".

But it can sometimes appeal to elderly couples because "especially after a lifetime together in which people have become fused with each other", you "no longer have to experience the death of the other, so you save yourself the grief".