Why a fortunate married couple decided to die together

Jan and Else have been married for almost five years. In early June, they died together after being given lethal treatment by two doctors. In the Netherlands this is called duo-euthanasia. It’s criminal, and it’s unusual – although every date, more Dutch couples decide to end their lives this way.

Some people will probably find this newsletter scary.

Three days before they anxiously draw their last breaths, Jan and Else’s campervan sits on a clear marina in Friesland, in the north of the Netherlands. They are a couple who love to live cellularly and have lived on motorhomes or boats for most of their marriage.

“We sometimes tried[living]in a pile of stones – a house,” jokes Jan, after I once asked him for advice, “but it doesn’t work.”

He is 70, and sits in the revolving driving-seat of the van, with one leg folded under him in one place to ease his persistent back pain. His wife, Else, is 71 and has dementia. Now, she struggles to form her sentences.

“This is great,” she says simply, standing up and pointing to her body. “But it’s terrible,” she says, pointing to her head.

Jan and Else met in kindergarten – their partnership was to last a lifetime. When he was young, Jan played hockey for the Netherlands national early years team, and later became a sports teacher. Else is skilled as a leading college lecturer. But it was certainly their shared love of water, boats and sailing that underlined their years together.

As a tender couple they lived on a houseboat. He purchased the nearest shipment boat and built a business transporting goods across the inland waterways of the Netherlands.

Meanwhile, Else gave birth to her best son (who requested anonymity). He became a weekly boarder in the classroom and spent weekends with his parents. During college holidays, when their child was also on board, Jan and Else looked for business trips that would take them to interesting parks – along the Rhine River, or to the islands of the Netherlands.

By 1999, the inland shipment business had become very aggressive. Jaan had been suffering from severe back pain due to the heavy lifting he had been doing for more than a decade. He and Ales left the area, but over the next few years they were again living on a ship. When it grew to the point of dominance, he bought his own giant campervan.

Jaan had back surgery in 2003, but she did not get stronger. He had stopped taking painkillers and could not work, but Els was still busy teaching. Occasionally they discussed euthanasia – Jan explained to his public that he did not want to live very long with his physical constraints. This happened after the pair joined NVVE – the Netherlands’ “right to die” organisation.

“If you take too many drugs, you live like a zombie,” Jan advised me. “So, because of my pain and Else’s illness, I think we have to stop it.”

When Jan says “stop it”, he goes further – refuse to stay.

In 2018, Ales retired from directing. He was showing early signs of dementia, but refused to see a doctor – perhaps because he had witnessed his father decline and die from Alzheimer’s. However, there came a time when his symptoms could not be ignored.

In November 2022, next diagnosed with dementia, Else walked out of the therapist’s consulting room, leaving her husband and son behind in resignation.

“She was furious – like a raging bull,” recalls Jain.

After Else realized that her position would not be strong she and Jan, along with their son, began talking about couple-euthanasia – the two of them died jointly.

Within the Netherlands, euthanasia and assisted suicide are criminal if someone requests it voluntarily, and their suffering – physical or mental – is classified by doctors as “intolerable” without the possibility of progression. Every person requesting an assisted death is classified through two documents – the second checks the analysis done through the primary.

In 2023, 9,068 people died through euthanasia in the Netherlands – about 5% of total deaths. There have been 33 cases of couple euthanasia, and a crowd of 66. These are complex matters which become even more serious if a significant partner has dementia, where there may also be uncertainty about their ability to provide consent.

“Many doctors don’t even want to think about performing euthanasia on a patient with dementia,” says Dr. Rosemarijn van Bruckem, a geriatrician and ethicist at the Erasmus Clinical Center in Rotterdam.

This used to be the location of Jan and Else GP. And this reluctance among doctors is reflected in the euthanasia statistics. Of the hundreds of people who died in 2023, 336 had dementia. So how do physicians assess the criminal necessity of “unbearable suffering” in patients suffering from dementia?

Dr. van Bruckem explains that for many people suffering from early-stage dementia, it is the uncertainty about how things will progress that will lead them to think about erasing their past.

“Will I not be able to do the things I feel are important? Will I no longer recognize my family? If you can express it adequately, if it is comprehensible to both the doctor wishing to perform euthanasia and the (second) doctor specializing in mental competency, the existential fear of what is to come may be reason to consider euthanasia. to do.”

Unenthusiastic about talking to their GP, Jan and Else contacted the Experience Center on Euthanasia – a cellular euthanasia therapy institute. It monitored about 15% of the assisted deaths in the Netherlands at the closing date, and, appropriately, grants about a third of the requests it receives.

When it comes to a couple who wants to end their life together, doctors must make sure that one spouse is not affecting the other.

Dr. Burt Keizer has participated in two couple euthanasia cases. However he also remembers meeting another couple when he suspected that the man was forcing himself on his wife. At an additional consultation, Dr. Kaiser spoke to the abandoned woman.

“He said he had a lot of plans…!” Dr. Kaiser says, explaining that the woman clearly realized that her husband was seriously ill, but disagreed with her plan to die with him.

The process of euthanasia was stopped and the person died of herbal causes. His wife is still alive.

Dr. Theo Boer, patron of health care ethics at the Protestant Theological College, is among the few vocal critics of euthanasia in the Netherlands, and believes that advances in palliative care continue to outweigh the desire for its usefulness.

“I would say that murder by a doctor can be justified. However, there must be exceptions to this.”

What worries Dr. Boer is the impact of couple-euthanasia cases – notably one of the Netherlands’ most important former prime ministers and his wife who decided to die together before this date, and around the world. Made headlines.

“We have seen dozens of cases of couple-euthanasia in the past year, and there is a general trend of ‘hero-ify’ dying together,” says Dr. Boer. “But the taboo on intentional killing – that’s coming to an end, and especially when it comes to couple-euthanasia.”

Jan and Else could possibly live in their campervan indefinitely. Do they think they will die soon?

Else says, “No, no, no – I can’t see it.”

Her husband says, “I’ve lived my past, I don’t need the pain anymore. We’re getting old for the life we’ve lived. We feel like it has to stop.”

And there is one more thing. Else has been evaluated by doctors, who say she is still initiating the change to decide for herself whether she wants to die — but that could change if her dementia becomes more complex.

None of this has been easy for Jan and Else’s son.

“You don’t want to let your parents die,” Jan explains. “So there were tears – our son said, ‘Better times will come, better weather will come’ – but not for me.”

Else feels the same way.

“There is no other solution.”

The generation before their appointment with the euthanasia doctors, Else, Jan, their sons and grandchildren have lived together. Ever the sensible one, Jan wanted to provide an explanation for the specifications of the campervan, so that he would be able to promote it.

“Then I went for a walk on the beach with my mother,” says his son. “Children were playing, some jokes were going on… it was a very strange day.

“I remember we were having dinner in the evening and I had tears in my eyes seeing us all having our last dinner together.”

On Monday morning everyone gathered at the local Dharamshala. The couple’s best friends were there, both Jan and Else’s brothers, and their daughter-in-law with her son.

“We spent two hours together before the doctors came,” he says. “We talked about our memories… and we listened to music.”

Idlewild via Travis for Else, Beatles Now and Nearest for January.

“The last half hour was tough,” says his son. “The doctors came and everything happened quickly – they follow their routine, and then it’s just a matter of minutes.”

Else van Leuningen and Jan Faber were given fatal treatment by doctors and died together on 3 June 2024.

Yet their campervan has not been launched into the market. Else and Jan’s son have decided to stock up a little and move on happily with his wife and children.

“Eventually I’ll sell it,” he says. “First I want to make some memories for the family.”