Miriam de Bontridder is a Board Member of the Foundation The Einder. Here we talk about her life, views, and work.
Scott Douglas Jacobsen: What was early life like for you, e.g., geography, culture, language, religion or lack thereof, education, and family structure and dynamics?
Miriam de Bontridder: The first 17 years of my life I lived in a small village in Flanders (Belgium). I have had a Catholic upbringing and until I went to Ghent for my studies, my mother required me to attend Mass every Sunday, even though I did not believe in (a) god since I reached the age of 13.
I was raised with rural values that were characterized by solidity.
Jacobsen: What levels of formal education have been part of life for you? How have you informally self-educated?
De Bontridder: At the University of Ghent (at the time a stronghold of progressivity) I studied Philosophy and then Law. I continued my law studies in Amsterdam, where I graduated in Dutch law and in International law. At the end of my career as a lawyer, I became deputy judge at the high court in Amsterdam.
Jacobsen: What tasks and responsibilities come with the Board Member position for Foundation The Einder?
De Bontridder: In 2013 I was approached to join the board of De Einder as a volunteer and to take on the portfolio of legal affairs there.
About De Einder I just knew at that time that it was founded in 1995 by a department of the Humanist Alliance in connection with two briefly successive events that took place in the same region. First a young man who jumped from an eleven storey apartment with death as a result, then a young woman who has thrown herself in front of a train with amputation of her lower limbs and a psychological trauma that could no longer be healed.
The question arose: ‘how to humanise suicides’ in the sense that someone who does not want to continue living is no longer dependent on cruel methods and means and where bystanders or relatives are spared as much as possible.
The question can also be described differently: how to prevent suicide? Not in the sense of what has come to be known as suicide prevention. No, in another sense, in the sense that the suicide is stripped of all horror and turned into a careful consideration process in which a person of sound mind, without being dependent on a physician, ends his life in a humane way after having gone through a rational and emotional process of consideration which ends up with the substantiated judgment that life has nothing or almost nothing positive for him anymore in prospect.
This form of suicide – stepping out of life without the intervention of a physician and using humane methods after a careful weighing process has been completed – De Einder calls ‘self-euthanasia’ or ‘a careful suicide’.
As there is a provision in Dutch criminal law that makes assistance with suicide punishable the peculiar situation arises that cruel suicides are not in violation of the law, but careful suicides may conflict with the law. With regard to the prohibition of assisted suicide in the Dutch penal code case law has arisen in which a distinction is made between punishable and non-punishable assistance in suicide.
What is allowed:
- to provide general information
- to give moral support (possibly by being present at the moment of suicide)
- to conduct conversations about the intended suicide
What is not allowed:
- to encourage suicide
- to provide resources such as medicines intended for suicide
- to instruct in the sense of giving an assignment with the intent that it is carried out
- to take over the control
- to carry out support activities around the execution
For the consultants of De Einder who inform people about how they can find death in a peaceful way, it is important that they act within the limits of the law. It is my task to supervise this.
Jacobsen: What have been some of the main struggles and victories for Foundation The Einder?
De Bontridder: Let me tell you what De Einder does. With that I give you both an image of its struggles and of its victories.
The vision and mission of De Einder is to discuss and implement a human death which is registered by the person himself. What does that mean? By ‘a self registred human death’ De Einder understands the completely voluntary decision to realise the end of one’s own life using humane methods after a careful consideration process has taken place at which the legitimate interests of others have been taken into account.
According to De Einder, the fact that people have not asked for their own birth does not mean that they are also not allowed to control their death. In De Einder’s view, everyone has the right to decide on his own end of life, even if that decision leads to the termination of that life. De Einder stands up for a right to die.
For the sake of convenience I define the right to die as the right whereby someone with a death wish who fully oversees the consequences of carrying out this wish and who takes the legitimate interests of others into account in his decision making process, has access to safe and reliable means that result in a peaceful, self-chosen human death or has access to someone who is prepared to execute his wish to die peacefully.
People who come to De EInder sometimes have an acute death wish and sometimes have only a future death wish.
People with an acute death wish often suffer from chronic physical or psychological problems, or don’t feel heard by their GP or specialist, or have been informed that their request can not be treated within the euthanasia law, or consider their lives as completed or do not want to use aggressive suicide methods.
People who do not have a direct death wish, are often driven by a desire to be in the possession of preventive means in order not to be dependent on their doctor.
Objective of De Einder is to provide moral support to people who are planning their final phase of life. This moral support is offered by consultants who guide people in clarifying their often ambivalent feelings and thoughts with regard to end-of-life decisions. In a personal meeting De Einder’s consultants discuss with the person concerned the questions and possible doubts with respect to the choices that are being considered by him. Most often such conversations are centred around the most radical decision that a person can take: the decision to end his own life. Those who are faced with such a decision feel the need and deserve to submit their considerations – and their questions and doubts – to someone who is familiar with end-of-life decisions. Someone who has enough distance to avoid identification with the client but who is also empathic enough to understand his death wish. Someone whose most important concern is that the client takes a well-considered decision with regard to the question to be or not to be. Someone who can ensure that the person who has taken a well-considered decision to commit suicide, says goodbye to the world in harmony and intimacy with his social environment.
Sensitive issues that the consultant is paying attention to are questions such as if the person concerned is of sound mind, if he is competent to fully oversee the consequences of his intention to step out of life and if he is capable to implement himself all steps to end his life without bringing other people into danger. Furthermore, it must be sure that an applicant’s wish to die is completely voluntarily, without there being any implicit or explicit pressure that others have exerted on him. In addition, an applicant must take into consideration the legitimate interests of others when deciding to step out of life. And finally, it must be plausible that self euthanasia is indeed the only alternative that remains for the applicant.
The consultant fulfils the role of discussion partner in the deepening of the issues discussed above and not the role of someone who makes demands. If the person seeking assistance does indeed consistently hold on to his opinion that life has little or nothing positive to offer and is mainly suffering, the consultant will inform the person concerned of how to achieve a peaceful and dignified death.
For each observer, the following must be an eye-opener: the science of how to obtain access to reliable euthanatics takes away so much fear and tension from the person concerned and creates such a great reassurance that even with ease the decision is taken to continue living. Speaking about the death wish gives such a great relief, and having the relevant information offers people such a high level of security, that people often derive the strength to take up therapy again. It is the tension of ‘not being able to talk about’ – often out of fear of engaging the crisis service or anxiety for the judgmental opinion of relatives and third parties – which can lead to obsession with the death wish and make this whish overpowering.
Jacobsen: In consideration of the upcoming battlegrounds, so to speak, what will be the next areas of activism in the next decade, for Foundation The Einder?
De Bontridder: During the time that De Einder was founded and many years later, little was known about human suicidal methods and drugs. The Einder had to invent the wheel here. “How to prevent potential suicides from using horrendous means and methods for themselves and their environment?” was a question in a field that nobody had any experience with.
Around the turn of the millennium information about humane suicides and methods were described in the so-called Scottish book that in the Netherlands was only clandestine available. This WOZZ booklet was published in 2003 by the Scientific Research Foundation for Careful Suicide (WOZZ). In 2006, The Peaceful Pill Handbook by Philip Nitschke and Fiona Stewart appeared and in 2010 the first edition of the book ‘Uitweg’ by Boudewijn Chabot and Stella Braam was published. These last two books contain a wealth of information with respect to the question of how to end your life in a humane way.
With the arrival of Uitweg and the later editions of The Peaceful Pill Handbook, in which addresses were included to order the desired euthanatics, the focus of De Einder has shifted. There is now more attention for the question on whether the existing euthanasia law should not be extended.
The current euthanasia law is suitable for what it is meant for: enabling the physician to honour a request for euthanasia by a patient suffering from a medical disease. The current law enables doctor’s euthanasia.
De Einder is of the opinion that there should also be a law that makes a careful suicide possible for a person who suffers existentially. Think of the ‘completed life ‘of elderly who are not sick but who ‘suffer from life’. According to De EInder, someone who suffers from life must be able to end his life with the help of euthanatics made accessible by the government and without being dependent on the personal moral values of a doctor.
About such a second law it is said that it would form a bomb under the current euthanasia law. My preliminary judgment is that this does not have to be the case:
It is self-evident that strict requirements are imposed on doctor’s euthanasia where a person requests someone else, i.e. the doctor, to end his life. But self-euthanasia where a person takes his own life by means of a euthanatic which he can – with or without the aid of intimates or end-of-life counselors – request from a government agency that only performs a marginal test on formal requirements (such as for example if the wish to die is not born under pression of others), does not have to meet the strict requirements posed to doctor’s euthanasia.
Jacobsen: What are the more local issues? Of these local issues, what ones link to the more international problems for the global community or organizations linked with FoundationThe Einder?
De Bontridder: Local issues are not at stake. At stake our universal values as the right to live and to right to die when life is unbearable.
Jacobsen: How does Foundation The Einder provide a solid basis upon which to change the legal conditions and sociocultural conversation around right to die issues?
De Bontridder: My answer would be too legal and too technical, could we skip this question?
Jacobsen: How is the Nederlands more progressive on euthanasia issues than other nations? How does the social health of the nation improve with these progressive measures taken by Nederlands? How can other countries learn from its example?
De Bontridder: May I reformulate this question? Would an organization like De Einder be helpful in other countries? Could other countries benefit from an organization that dedicates itself to turning the number of cruel suicides into suicides that can carry the predicate ‘carefully’?
An organization like De Einder does not exist in any other country than the Netherlands. The impression exists that self-euthanasia, ‘the careful suicide’, is still a subject that is taboo in most other countries.
Could it be the case that there occur more cruel suicides in these countries while in the Netherlands more ‘careful suicides’ take place?
There is no scientific research with respect to this question, but if such research comes I guess it could lead to interesting conclusions.
Jacobsen: How can people become involved with donation of time, addition of membership, links to professional and personal networks, giving monetarily, and so on?
De Bontridder: I am afraid we cannot be of much help for Canadian people seeking for end of life assistance. And we neither can offer them possibilities to get more involved in our organization.
Jacobsen: Any final feelings or thoughts based on the conversation today?
De Bontridder: No particular thoughts or feelings,thank you for considering me for this interview.
Jacobsen: Thank you for the opportunity and your time, Miriam.
Scott Douglas Jacobsen is the Founder of In-Sight: Independent Interview-Based Journal and In-Sight Publishing. He authored/co-authored some e-books, free or low-cost. If you want to contact Scott: Scott.D.Jacobsen@Gmail.com.
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