[Nettime-nl] Reaction to a nettime reader who wrote me: "It is not without reason that the nazis passed the first laws on euthanasia. Not everything is about choice and nor should it be"

[Tjebbe van Tijen via Chello <t.tijen@chello.nl>]

On August 24 2012 I posted here on Nettime and also on my blog The Limping Messenger a short article

The Vegetative Prince Will Not Wake Up: Dutch Prince Friso medical ethics and the ordeal of social inequality

Posted under this URL: http://wp.me/pw0cu-1w3

I did get a reaction via email from a participant of Nettime and my disagreement at first read lead me to reflect better on it, which produced the following argument:

> The liberal Dutch laws did result in over two thousand people being killed without their permission in the first two years of its operation according to a Dutch government report. There its another dark side to the right to death debate that many liberals simply ignore. It is not without reason that the nazis passed the first laws on euthanasia. Not everything is about choice and nor should it be


Reply to Martin H.

I could not figure out the number of 2.000 Euthanasia cases without consent which you relate to a Dutch government report. Knowing the literature a bit that number makes no sense. Also the denominator "people being killed without their permission" is odd. There is the category "levensbeëindigend handelen zonder verzoek" (live-ending acts without a request), used in the euthanasia statistics. The Dutch State Statistical Bureau (CBS) publishes an overview on its web-site "Overledenen naar medische beslissing rond levenseinde" (Deceased according to medical decisions concerning the way in which their lives have been ended). It ranges from the year 2001 to the year  2010 and the number of (reported) cases where medical professionals have decided without patients  being (able to be ) consulted has gone down. The numbers are assembled on a 5 year basis: 2001 = 938; 2005 = 551; 2010 = 310. (1) For a more detailed report there is the report of ZonMw which is based on a evaluation research done in the year 2010. Also this report is on line (in Dutch) (2). The conclusions of this report are also avaialble as an article in The Lancet, published July 11th 2012. The abstract is on-line and to once more oppose your numbers I cite part of its conclusions:

"Findings
In 2010, of all deaths in the Netherlands, 2·8% (95% CI 2·5—3·2; 475 of 6861) were the result of euthanasia. This rate is higher than the 1·7% (1·5—1·8; 294 of 9965) in 2005, but comparable with those in 2001 and 1995. Distribution of sex, age, and diagnosis was stable between 1990 and 2010. In 2010, 77% (3136 of 4050) of all cases of euthanasia or physician-assisted suicide were reported to a review committee (80% [1933 of 2425] in 2005). Ending of life without an explicit patient request in 2010 occurred less often (0·2%; 95% CI 0·1—0·3; 13 of 6861) than in 2005, 2001, 1995, and 1990 (0·8%; 0·6—1·1; 45 of 5197)." (3)

You say there is "another dark side" and proceed without too much explanation of what you try to say, to the short-cut argument of the Nazis and their 'eugenic' program. Now that is less than what is needed to start any discussion of the ethics of life and death. I could first of all rebuke that there is "the dark side of suffering without any hope to a betterment." The agony of a medical prolonged life that has lost all its meaning, apart from the suffering. Yes, indeed there are many big dangers about who is deciding what and when. Law and regulations - however enlightened they may be in their formulation - will certainly be misused in certain cases. No law and no regulation, on the other hand may produce even more mishap.

Ethics are - in the end - not an instrument that can function in "the hands of the state", they need to function at the personal level. They need intimacy. Intimacy between a person from who live is slipping away and her or his caretakers. Not always is there an opportunity for such a very personal discourse on how far treatment should go. 

These cases produce part of the numbers that you have named "killed without their permission." You may have not had in mind to use such demagoguery, but for me I can not escape to read it as such. "Not everything is about choice. nor should it be" you write and that puzzled me. Is it your conviction of life as 'god given', or life as something of a bigger order than our own conscious being? Is there some higher plan that gives meaning to our suffering? 

I, for myself think so many things about this. Not always the same. One of them, which has come over the years and with many sad experiences of losing beloved ones in all kind of ways, is that as long as there is even a faint will of life, a refusal to go, life is meaningful. 

Of course all this only is meaningful when there is some slow process of decay, a slow way of dying. There are the sudden unexpected accidents, war and other man made violence, natural disasters, name it, that slash away any of this discussion of euthanasia.

One can witness - though - a moment of choice, an acceptance of dying. If you want to see that as god or nature given, please do so. Others may experience it within themselves as the last thing of their own.


(1) 
http://statline.cbs.nl/StatWeb/publication/default.aspx?DM=SLNL&PA=71438NED

(2) http://www.zonmw.nl/uploads/tx_vipublicaties/sterfgevallenonderzoek_versie_1-1_web-a4.pdf

(3) 
http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(12)61034-4/fulltext

Tjebbe van Tijen


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