Jan and Els sought medical intervention to end their lives after 50 happy years of marriage
Jan and Els were married for almost fifty years. In early June, they died together after receiving lethal drugs from two doctors. In the Netherlands, this practice is known as “duo-euthanasia.” It’s beautiful but rare, yet every year more and more Dutch couples choose to end their lives this way.
Aleta: Some people may find this article disturbing.
Three days before they voluntarily took their last breath, Jan and Els’ caravan sits in a sunny marina in Friesland, in the north of the Netherlands. They are a couple who love to travel and have spent much of their marriage in a camper or on a boat.
“Sometimes we try [viver] in a pile of rocks – a house,” Jan jokes when I visit, “but it doesn’t work.”
He is 70 years old and sits in the trailer’s swivel driver’s seat, one leg tucked under him in the only position that eases his persistent back pain.
His wife Els is 71 years old and suffers from dementia. She now has difficulty forming sentences.
“This is really nice,” he says, standing up easily and pointing to his body. “But this is terrible,” he says, pointing to his head.
Jan and Els met in kindergarten: theirs has been a lifelong collaboration. When he was young, Jan played hockey for the Dutch national youth team and later became a sports coach. Els trained as a primary school teacher. But it was their shared love of water, boats and sailing that defined their years together.
As a young couple they lived on a houseboat. They later purchased a cargo ship and started a business transporting goods along the inland waterways of the Netherlands.
In the meantime, Els gave birth to her only son (who asked to remain anonymous). She stayed at school during the week and spent weekends with her parents.
During the school holidays, when their son was also there, Jan and Els looked for business trips that would take them to interesting places, along the Rhine or on the islands of the Netherlands.
In 1999 the couple’s business became very competitive. Jan suffered from severe back pain due to the heavy work she had been doing for over a decade.
He and Els moved to the mainland, but after a few years they were living on a boat again. When the situation became difficult to manage, they purchased their own spacious trailer.
Jan had back surgery in 2003, but it didn’t improve. He stopped a heavy regimen of painkillers and couldn’t work anymore, but Els was still busy teaching.
Sometimes there was talk of euthanasia: Jan explained to his family that he did not want to live with his physical limitations for a long time. It was during this period that the couple joined the NVVE, the Dutch “right to die” organization.
“If you take too much medicine, you live like a zombie,” Jan told me. “So with the pain I’m in and Els’s illness, I think we need to stop all of this.”
When Jan says “stop it”, he means: stop living.
In 2018, Els retired from teaching. She was showing early signs of dementia but resisted seeing a doctor, perhaps because she had witnessed her father’s decline and death from Alzheimer’s. But there came a point where her symptoms could no longer be ignored.
In November 2022, after being diagnosed with dementia, Els ran away from her doctor’s office, leaving her husband and son behind.
“She was furious, like a raging bull,” Jan recalls.
It was after Els learned that her condition would not improve that she and Jan, along with her son, began discussing euthanasia as a couple: the two of them would die together.
In the Netherlands, euthanasia and assisted suicide are legal if someone requests it voluntarily and their suffering – physical or psychological – is assessed by doctors as “unbearable”, with no prospect of improvement. Each person who requests assisted death is evaluated by two doctors, the second verifying the evaluation made by the first.
Where to get help
*If you are or know someone who is showing warning signs related to suicide, or if you have lost a loved one to suicide, check out some places to get help:
- The Center for the Valorization of Life (CVV), through telephone 188offers a free 24-hour service; there is also the ability to chat, send emails and search for gas stations throughout Brazil;
- For young people aged 13 to 24 Unicef also offers the chat Can talk;
- In case of emergency, another recommendation from experts is to call the Fire Brigade (telephone 193) or to the Military Police (telephone 190);
- Another option is to call SAMU, at telephone 192;
- In the local public network it is also possible to ask for help at the Psychosocial Assistance Centers (CAPS), in the Basic Health Units (UBS) and in the 24-hour Emergency Units (UPA);
In 2023, 9,068 people died by euthanasia in the Netherlands, approximately 5% of total deaths. There were 33 cases of double euthanasia, for a total of 66 people. These are complex cases, even more so if one of the partners suffers from dementia, in which there may be uncertainty about his ability to give consent.
“Many doctors don’t even want to think about euthanizing a patient with dementia,” says Rosemarijn van Bruchem, a geriatrician and ethics officer at the Erasmus Medical Center in Rotterdam.
This was the position of Jan and Els’ doctor. And this reluctance among doctors is reflected in the euthanasia numbers. Of the thousands of people who died in 2023, 336 suffered from dementia. So how do doctors evaluate the legal requirement of “unbearable suffering” in dementia patients?
For many with early-stage dementia, it is the uncertainty about how things might progress that can lead them to consider ending their life, explains van Bruchem.
“Will I lose the ability to do the things I consider important? Will I no longer recognize my family? If this is expressed well enough, if it is evident to the doctor willing to practice euthanasia, as well as to the doctor [segundo] physician specializing in mental health, existential fear of what is to come may be the reason to consider euthanasia.”
Since their doctor was reluctant to help, Jan and Els looked for a mobile euthanasia clinic: the Euthanasia Specialist Center. Last year, it oversaw about 15 percent of assisted deaths in the Netherlands and, on average, grants about a third of the requests it receives.
In the case of a couple who want to end their life together, doctors must be sure that one partner does not influence the other.
Dr. Bert Keiser has already treated two cases of double euthanasia. But he also recalls meeting with another couple, when he suspected that the man was coercing his wife. On a subsequent visit, Keiser spoke to the woman alone.
“She said she had so many plans…!” says Dr. Keiser, explaining that the woman clearly knew her husband was gravely ill, but had no intention of dying with him.
The euthanasia process was stopped and the man died of natural causes. His wife is still alive.
Theo Boer, professor of health ethics at the Protestant Theological University, is one of the few outspoken critics of euthanasia in the Netherlands and believes that advances in palliative care often reduce the need for its use.
“I would say that death caused by a doctor can be justified. However, this must be an exception.”
What worries Boer is the impact of double euthanasia cases, especially after a former Dutch prime minister and his wife chose to die together earlier this year, which made global headlines.
“We have seen dozens of cases of double euthanasia in the last year, and there is a general tendency to ‘heroify’ joint death,” says Boer. “But the taboo surrounding intentional killing is eroding, especially when it comes to two-way euthanasia.”
Jan and Els could probably continue to live in their trailer indefinitely. Do they feel like they might die too soon?
“No, no, no, I don’t see it that way,” Els says.
“I’ve lived my life, I don’t want to feel pain anymore,” her husband says. “We’re getting too old for the life we lead. We think it has to stop.”
And there’s more. Els was assessed by doctors who said she still has the ability to decide for herself whether she wants to die, but this could change if her dementia progresses.
None of this was easy for Jan and Els’ son.
“You don’t want your parents to die,” explains Jan. “So there were tears – our son said, ‘Better times will come, better climates’ – but not for me.”
Els feels the same way.
“There is no other solution.”
The day before the appointment with the euthanasia doctors, Els, Jan, their son and their grandchildren were together. Always practical, Jan wanted to explain the peculiarities of the trailer so that it would be ready for sale.
“Then I went for a walk on the beach with my mom,” says the son. “The children were playing, there were pranks… It was a very strange day.
“I remember we were having dinner that night, and my eyes filled with tears seeing us all together at that final dinner.”
On Monday morning everyone gathered at the palliative care hospital. The couple’s best friends were present, as well as Jan and Els’s brothers and her daughter-in-law with her son.
“We spent two hours together before the doctors arrived,” he says. “We talk about our memories… And we listen to music.”
Idlewild by Travis for Els, Now and Then by The Beatles for Jan.
“The last half hour was difficult,” says the son. “The doctors arrived and everything happened quickly: they follow their routine and then it’s just a matter of minutes.”
Els van Leeningen and Jan Faber were given lethal drugs by doctors and died together on Monday 3 June 2024.
Their trailer has not yet been put up for sale. Els and Jan’s son decided to keep him for a while and go on holiday with his wife and children.
“I’ll sell it eventually,” he says. “First I want to create some memories for the family.”
*This report was born from Linda Pressly’s documentary “To love, live and die together“, available from Tuesday 2 July on BBC World Service. Listen, in English, on BBC Sounds.
Source: Terra
Ben Stock is a lifestyle journalist and author at Gossipify. He writes about topics such as health, wellness, travel, food and home decor. He provides practical advice and inspiration to improve well-being, keeps readers up to date with latest lifestyle news and trends, known for his engaging writing style, in-depth analysis and unique perspectives.
