Euthanasia in psychiatry is an emergent practice globally and in the US it is being referred to as 'the Dutch way'. I therefore decided to start a new topic that specifically addresses the political history of the practice in the Netherlands.
- Assisted Suicide and Euthanasia: Oregon Tries the Dutch Way
- The Dutch way of death - PubMed
Short introduction for this topic:
A few months before an attack on my home in 2019 (described here) I was using my Android phone which I almost never use and it continuously showed a remarkable advertisement for a tiny local newspaper of a far away town that I am in no way affiliated with: De Stentor. The advertisement reminded me of a 2010 report about the political extortion used to enforce euthanasia in psychiatry in The Netherlands.
In 2019, a Dutch critical blog on psychiatry that I was author of (www.zielenknijper.com) had been closed for many years (since 2014) and I wasn't involved with the subject anymore. I had closed the blog with the idea that change for the benefit of people would best come from within and not from outside criticism so I actually completely stayed away from the subject at that time.
Considering the persistence of the ad on the phone it was perceived as awkward. It incited a feeling of responsibility with regard my witnessing of the history of the corruption that resulted in legalization of euthanasia in psychiatry in the Netherlands. How could I leave those people unattended, considering what I knew?
I decided to do a quick search on www.madinamerica.com by medical journalist and bestseller author Robert Whitaker and I found a post about eugenics by Canadian anti-psychiatry scholar Bonnie Burstow. I replied to it.
(2019) “Psychiatric Eugenics Then and Now — You Betcha It’s Still Happening!”
“Those who cannot remember the past are condemned to repeat it.” (George Santayana)
https://www.madinamerica.com/2019/07/ps ... n-and-now/
My decision at that time - as a response to the ad and the feeling of responsibility that it had incited in me - was to start a topic about the subject on a philosophy forum. My first post on this forum was titled: Euthanasia in psychiatry: ethically?
In a way, the Google ad was the cause that I joined a philosophy forum and started to invest time to study it.
Two countries in Europe, the Netherlands and Belgium, were the first to allow euthanasia. In most other countries, including the UK, it has long remained illegal for doctors to kill their patients.
Initially, psychiatrists were excluded from the right to apply euthanasia. In 2010 Dutch psychiatrists enforced the right to euthanise their patients by officially releasing a guideline from the Dutch Psychiatric Association (NVvP) that instructed psychiatrists to release patients with a suicide wish so that they could commit suicide on the street.
The head of the Dutch union for railway personnel, mr. Wim Eilert, responded with the following:
This is a bad signal. Every year 200 people in the Netherlands jump in front of a train. These are horrific experiences for drivers and also for conductors. Some never come back to work. That is why suicide on the railways must be reduced as much as possible. When institutions let patients go to commit suicide, a number of them always ends before a train, because it is simply a certain path to death.
(2010) Doctors release patients for suicide
https://www.destentor.nl/algemeen/binne ... fmoord.ece
In a subsequent poll with psychiatrists in the Netherlands published on Skipr.nl, 75% of psychiatrists responded to approve of euthanasia as a treatment option and 43% responded that they would be willing to apply it.
Soon after the guideline, Dutch politics provided psychiatrists with the right to euthanise their patients and the numbers have been growing rapidly since. In 2010, the year of the guideline, 2 psychiatric patients were euthanised. In 2011 the number grew to 13 patients and in 2013 the number had grown to more than 50 patients.
Ten years later, translated to the US population, Dutch psychiatry has applied euthanasia to 40,000 psychiatric patients.
Years leading up to the guideline: blackmailing
The years leading up to the guideline had seen a lot of mainstream media attention for scandals in psychiatry and it was often cited that psychiatry turned to blackmailing to hide their wrongdoing.
In 2010, shortly before psychiatrists were given the right to euthanise their patients, politician Halbe Zijlstra (from the then ruling party VVD) raised the alarm about a measure demanded by the mental health organizations to hide their wrongdoing from the public. The demand was a response to the many scandals that had hit the news and as such it became evident that psychiatry intended to hide their wrongdoing and resorted to political blackmailing to meet their ends.
(2010) Halbe Zijlstra (VVD): “Psychiatry is blackmailing to hide scandals”
According to MP Halbe Zijlstra, there is talk of "blackmail practices" intended to "cover up mistakes and abuses".
https://www.skipr.nl/actueel/ggz-morrel ... 52225.html
The minister of Public Health Ab Klink agreed with the concerns raised by the MP. In the years before, the minister had expressed his dissatisfaction with the state of affairs in psychiatry several times and announced that measures had to be taken.
(2008) Minister Ab Klink demands a lower limit for the quality of care in psychiatry
https://www.volkskrant.nl/vk/nl/2686/Bi ... trie.dhtml
The minister was involved in a legal battle with mental health organizations for an announced budget measure for psychiatric care of 120 million euros. In the lawsuit, the organizations argued that they "couldn't do anything about it" that there are more and more psychiatric patients.
The organizations mentioned the following in the lawsuit against the minister which shows their anger towards him.
“The demand [for psychiatric care] has increased and therefore more is being spent on care. But that's not our fault, is it? We also think that the minister has nothing to do with it at all. This is something between us, the health care authority and the health insurers,” says chairman Marleen Barth of GGZ Nederland. “We are critically monitoring the minister's announced measure. It has no effect on its own budget,” confirms a spokesperson for the Dutch Healthcare Authority.
“It is not yet possible to quantify the exceedance at all. The institutions are currently still preparing the accounts,” said an indignant Barth. “In addition, people only receive help from us if they have been referred by a general practitioner, for example. It's not that we create that demand ourselves.”
(2010) Minister Ab Klink (Public Health) sued by psychiatry
Psychiatrists furious with Minister Klink: budgetary measure is a noose for psychiatry.
https://www.telegraaf.nl/binnenland/419 ... html?p=7,2
The mental health organizations lost the lawsuit.
As if the mental health organizations intended to revolt against the minister, less than three months after the lawsuit, the mental health organizations started a millions of euros costing national propaganda campaign called "1 in 4" to lower the threshold for psychiatric care (www.1opde4.nl). This campaign was banned shortly after by the Advertisement Authority (Reclame Code Commissie) because the advertisement would be misleading and untruthful. The campaign included full page advertisements in newspapers costing up to 60,000 euro per day.
The domain holder of the domain 1opde4.nl was Maximum Recruitment Advertising.
Why given the right to apply euthanasia?
It is seen in the preceding history that in 2010, politicians seek public media attention for “blackmailing” by psychiatry and that same fact came to light in the political extortion used to obtain the right to apply euthanasia.
Patients with a suicide wish were being released to commit suicide on the street which looked like a political extortion tactic.
Why did psychiatry receive the right to euthanise patients at that specific time?
With euthanasia, psychiatry is much stronger in hiding potential wrongdoing.
It doesn’t seem logical that politicians would have ‘given in’ to extortion at that time, considering the public shout out about the occurrence of such practices by a ruling party politician with support by a Public Health minister several months before. But if political extortion wouldn’t have been required to get euthanasia legalized, why would the Dutch Psychiatric Association have used such a tactic? If anything, it shows a lack of care for their patients and for society by essentially letting patients jump in front of a train.
The end result is simple however. Psychiatrists obtained and used their right. Patients were being euthanised and it reached the international news (BBC).
Antidepressant treatment controversial
Antidepressants have suspicious side effects while a fake pill with a side effect (active placebo) that gives users the feeling that something is happening in the body, is proven to be just as effective as antidepressants in patients with a clinical major depression.
(2008) Effectiveness of antidepressants: an evidence myth constructed from a thousand randomized trials?
Antidepressants double to tenfold the risk of suicide and hundreds of professors raised the alarm that antidepressants can have extreme violence as a side effect. Some magazines even published covers with the title “Killer Pills”.
- (2010) A criminal side effect
There is no hard scientific evidence that antidepressants can be the cause of extremely violent behaviour, but the evidence is piling up.
https://en.zielenknijper.com/pdf/trouw- ... erking.pdf
- (2009) Pills of the Devil
https://en.zielenknijper.com/images/rev ... -pills.jpg
- (2008) Cheating with suicide rates: Miracle pill, fake pill, suicide pill
‘Given up’ patients often made chronically ill by psychiatry
There is a large group of patients who are called “given up”, however, there are many psychiatrists and mental health specialists who do not accept the term “given up”, especially with youngsters, and some claim that psychiatry is often the cause of the chronicity of problems in those patients.
Dr. Detlef Petry, who is specialized in the group “given up” patients, mentions that 80% of the “given up” patients in his clinic recovered using an innovative non-medical approach that he called “rehistorization” or “biographical developmental thinking”.
(2014) Dr. Detlef Petry: Patients are deliberately put to an early death with antipsychotics
Long-stay patients belong to the group that has been written off. The long-stay departments house chronic mentally ill for whom, according to classical psychiatry, no future is left. It gave Dr. Petry the name of “psychiatrist of the craziest”. But the patients are not written off in the eyes of psychiatrist Detlef Petry. When chronic patients have degenerated into houseplants, people who come to nothing and do nothing anymore, the chronicity of their problems is often caused by antipsychotic medications, he argues in his book “The Unmasking”.
With regard to the 'choice' to end life. If, after a few years, patients with a suicide wish are told by their trusted doctor that euthanasia is an option, it makes sense that they will make that choice, if only to prove that their problems are real. It could also be a kind of social stamp for many people to prove that their problems are the most serious.
If euthanasia is not possible, then people may unknowingly be forced to consider that there must be a way out somehow, giving specialists options to lead someone to recovery.
Philosopher Friedrich Nietzsche in The Genealogy of Morals (Third Essay) argues that in response to a lack of ability to answer questions related to the purpose of life, people will rather choose to commit suicide than to choose nothing at all.
“If you except the ascetic ideal, man, the animal man had no meaning. His existence on earth contained no end; “What is the purpose of man at all?” was a question without an answer; the will for man and the world was lacking; behind every great human destiny rang as a refrain a still greater “Vanity!” The ascetic ideal simply means this: that something was lacking, that a tremendous void encircled man—he did not know how to justify himself, to explain himself, to affirm himself, he suffered from the problem of his own meaning. He suffered also in other ways, he was in the main a diseased animal; but his problem was not suffering itself, but the lack of an answer to that crying question, “To what purpose do we suffer?” Man, the bravest animal and the one most inured to suffering, does not repudiate suffering in itself: he wills it, he even seeks it out, provided that he is shown a meaning for it, a purpose of suffering. Not suffering, but the senselessness of suffering was the curse which till then lay spread over humanity—and the ascetic ideal gave it a meaning! It was up till then the only meaning; but any meaning is better than no meaning; the ascetic ideal was in that connection the “faute de mieux” par excellence that existed at that time. In that ideal suffering found an explanation; the tremendous gap seemed filled; the door to all suicidal Nihilism was closed. The explanation—there is no doubt about it—brought in its train new suffering, deeper, more penetrating, more venomous, gnawing more brutally into life: it brought all suffering under the perspective of guilt; but in spite of all that—man was saved thereby, he had a meaning, and from henceforth was no more like a leaf in the wind, a shuttle-cock of chance, of nonsense, he could now “will” something—absolutely immaterial to what end, to what purpose, with what means he wished: the will itself was saved. It is absolutely impossible to disguise what in point of fact is made clear by complete will that has taken its direction from the ascetic ideal: this hate of the human, and even more of the animal, and more still of the material, this horror of the senses, of reason itself, this fear of happiness and beauty, this desire to get right away from all illusion, change, growth, death, wishing and even desiring—all this means—let us have the courage to grasp it—a will for Nothingness, a will opposed to life, a repudiation of the most fundamental conditions of life, but it is and remains a will!—and to say at the end that which I said at the beginning—man will wish Nothingness rather than not wish at all.”
There are strong indications that psychiatry exacerbates problems and makes them chronic. That makes it ethically irresponsible to allow psychiatrists to euthanise their patients, even though there may be situations in which people can genuinely choose to end their lives while there is nothing wrong with their body. The fact that – in view of the fierce criticism of psychiatry by many scholars – it cannot be excluded that psychiatry has provided inadequate care or even had a detrimental influence on the opinion and decision-making of an individual, makes it ethically irresponsible to allow psychiatrists to euthanise their patients.
Some perspectives of users on this forum:
“Euthanasia is at least for psychiatry the biggest hoax i ever heard of. To use psychological diagnostics for aid of something for euthanasia is disgusting. Psychological deseases cannot be compared to painful cancer or ebola where death may seem secure and super painful.”
“I can agree with the availability of the choice to competent folks suffering from serious physical problems, but I am struggling to see the acceptable scenario for suicide based on mental problems.”
Philosopher Albert Camus
The following podcast from a group of philosophy professors examines the work of the French philosopher Albert Camus who has explored the concepts suicide and reason to live.
(2009) Episode 4: Camus and the Absurd
Does our eventual death mean that life has no meaning and we might as well end it all? Camus starts to address this question, then gets distracted and talks about a bunch of phenomenologists until he dies unreconciled. Also, let's all push a rock up a hill and like it, okay?
https://partiallyexaminedlife.com/2009/ ... he-absurd/
1) What is your opinion on euthanasia in psychiatry?
2) What do you think of the political extortion used to enforce legislation of euthanasia in psychiatry? How can it be explained?