Death, In This Time

Kevin Yuill and Theo Boer write:

There has not been, in living memory, more focus on healthcare, the vital role of doctors, the sacrifices made by nurses, and the wonderful efforts of everyone involved in the sector.

Amid the coronavirus crisis, daily heroism, the scale of human loss, and the awful scenes in hospitals underline what is important – and what is not.

It will surprise some that in the Netherlands, the only dedicated clinic providing euthanasia and assisted suicide has closed. Euthanasia Expertise Centre (formerly known as End of Life Clinic) has suspended all euthanasia procedures. 

The clinic’s website says that existing procedures have been put on hold and new patients are no longer admitted.

The centre – which in 2019 alone ended the lives of 898 patients suffering from cancers, psychiatric problems, early on-set dementia, and accumulated age-related complaints – is willing to make an exception only for those expected to die soon and those who may soon lose their capacity for decision-making.

Similarly, in Belgium, Jacqueline Herremans, a member of the federal commission reviewing euthanasia, has noted that there are few resources and even fewer doctors available for euthanasia at the moment: ‘The most important thing right now is that we fight the coronavirus.’ 

In Canada, authorities are also shutting down services. For a process that requires two different medical assessments and witnesses, the lives involved are not worth the risk. 

According to the Globe and Mail, two places in Ontario, where euthanasia and assisted suicide have been legal since 2016, have stopped providing medical assistance in dying (MAID) because of the coronavirus pandemic (one has since resumed for existing patients and those whose deaths are imminent).

The Euthanasia Expertise Centre explains its decision on its website, noting that in ‘the interest of public health, our patients, their loved ones and employees of the expertise centre, it is no longer responsible to continue our current care provision’. 

As it admits, ‘euthanasia care cannot be identified as a top priority in healthcare’. In Canada, health authorities said that MAID is being cut back along with other ‘elective services’. This is an extraordinary admission. 

Those carrying out euthanasia in the Netherlands, where euthanasia and assisted suicide are legal, and those campaigning to change the law in places like the UK, have long insisted that assisted dying is necessary to alleviate ‘unbearable suffering’. 

shut down euthanasia clinics and services because of the danger of infection from Covid-19 means that those who perform euthanasia no longer believe their services are necessary; otherwise, many of them would brave the risk and despatch suffering patients.

Stephen Pleiter, director of the Euthanasia Expertise Centre, stated last year that, ‘If the situation is unbearable and there is no prospect of improvement, and euthanasia is an option, it would be almost unethical [of a doctor] not to help that person’.

In Canada, MAID is a constitutional right. In Britain, Nick Boles MP introduced a gruesome description of suffering at the end of life in the UK by saying that the lack of provision of assisted dying forces people to ‘undergo unbearable physical and psychological trauma’, which, he said, was ‘a moral outrage’.

But suddenly, where it is legal, it doesn’t seem so necessary. This is in stark contrast to hospice services, who continue their vital service to the dying despite all of the risks involved.

According to the Dutch Association of Hospice Care there are no reports of hospice closures in the Netherlands.

Hospices in Ontario, where MAID services have shut, continue to operate, rapidly organising themselves to accommodate palliative care for terminally ill Covid-19 cases.

In the UK, hospices are reported to be extraordinarily busy; in Scotland, at least one has joined forces to provide care for Covid-19 cases requiring palliative care.

Most are full and senior staff are ‘managing lots of clinical queries and huge fear and anxiety’, one hospice doctor reported.

They are included in Covid-19 planning groups, as this NHS document indicates. Their staff have continued working despite the crisis. 

What the Covid-19 crisis has demonstrated is that the need for euthanasia and assisted suicide is abstract rather than practical.

In the Netherlands in the 1980s, assisted dying started out as the ultimate solution to impending horrible deaths.

In present times, with a high level of care for the dying available in most countries with good healthcare, assisted dying is not about actual deaths, but about deaths that people fear.

The reality is that most people die peaceful deaths. But many fear loss of control and find the prospect of others caring for them terrifying.

Covid-19 brings the reality of death, the necessity of caring for others and being cared for by others, into our living rooms, making the preciousness of all lives and the tragedy of all deaths real.

We see the humanity of the elderly and frail; no longer are they burdens to be despatched from this world, but victims of horrifying disease that all are invested in fighting.

Those who work in euthanasia clinics are caring, dedicated people who usually feel that they are doing good. 

They are not cowards – many are being deployed to fight the virus. 

But their stock in trade – the existential angst about death that seems to make euthanasia a necessary human right – has disappeared in this time of crisis. 

Death, in this time of war against a disease, no longer appears a comforting friend or a useful medical treatment. 

Covid-19 brings the reality of death, the necessity of caring for others and being cared for by others, into our living rooms, making the preciousness of all lives and the tragedy of all deaths real. 

We see the humanity of the elderly and frail; no longer are they burdens to be despatched from this world, but victims of horrifying disease that all are invested in fighting.

Those who work in euthanasia clinics are caring, dedicated people who usually feel that they are doing good. 

They are not cowards – many are being deployed to fight the virus. 

But their stock in trade – the existential angst about death that seems to make euthanasia a necessary human right – has disappeared in this time of crisis. 

Death, in this time of war against a disease, no longer appears a comforting friend or a useful medical treatment.

In a few months we may return to normal, in which case euthanasia clinics will return to granting people’s wishes to no longer be, to escape this life, or to be in control of their deaths.

Perhaps, though, we can remember this time when we made huge sacrifices to preserve every life, no matter how frail and vulnerable.

We can remember this time when euthanasia no longer seemed necessary.