‘Levenseindekliniek’ by Marcel Ouddeken, Hans Kema

The End-of-Life Clinic, founded in 2012, receives numerous requests annually from patients who wish to end their suffering, but whose requests for euthanasia are not straightforward. The documentary Levenseindekliniek (Dutch for 'End-of-Life Clinic') portrays three challenging euthanasia cases. The filmmakers follow the patients during their discussions with the clinic’s doctors, as well as in their daily lives, and interview them, their loved ones, the doctors, and the director of the End-of-Life Clinic, Steven Pleiter. The first patient, Hannie Goudriaan (69), suffers from semantic dementia, which affects her language. According to a clinic doctor, Remco Verwer, this makes it difficult to determine if she is competent to make decisions. However, based on the conversations Verwer has had with Mrs Goudriaan, he believes that her wish to die is clear. Furthermore, he indicates that her living will, which contains a dementia clause, clearly indicates how she would judge her current situation. The second patient, Joop Vervloet (60), has been suffering from compulsive thoughts and actions almost his entire life. Driven by obsessive thoughts, he cuts himself with glass every nine days. The psychiatrist from the End-of-Life Clinic, Gerty Casteelen, judges that Mr. Vervloet’s suffering is hopeless and unbearable, and decides that he qualifies for euthanasia. The third patient, 100-year-old Ans Dijkstra, feels that her life is complete. She no longer finds pleasure in life, struggles with a range of age-related ailments, and has recently lost her son. The clinic doctor, Willem Spiers, believes that he can provide euthanasia in conformity with the guidelines of the law. It is noteworthy that both Verwer and Casteelen state that the End-of-Life Clinic is at the ‘euthanasia forefront’, exploring a new approach to death because they take requests from patients that are rejected by most doctors. Of the doctors who were treating the three patients on a regular basis, only Mrs. Goudriaan's general practitioner is interviewed. He explains that he did not want to comply with her request for euthanasia because, firstly, he did not receive sufficient support from the independent physician and the neurologist, and secondly, he was not entirely convinced of her wish to die.

The documentary sparked heated debate in the Netherlands, both in the media and in politics. Two members of small Christian factions in parliament asked the Minister of Health about questions it raises. Particularly, the euthanasia of Mrs Goudriaan received a lot of criticism, mainly because her desire to die was deemed unclear, and because it was thought the unbearableness of her suffering was not demonstrable. Mrs Dijkstra’s case fueled the public debate on euthanasia for completed life, especially as a committee had just advised against expanding existing legal options regarding assisted suicide. Although the committee argued that persons without a medical condition should not be eligible for euthanasia or assisted suicide under current Dutch law, the question was also whether a clear line can be drawn between completed life and multiple geriatric symptoms, as physicians use the presence of multiple geriatric symptoms in patients who formulate their euthanasia request in terms of completed life as a criterion for eligibility. The Regional Euthanasia Review Committees reflect on the documentary in their annual reports for 2015 and 2016. The Committees emphasize that based on the files of the notifying doctors, independent doctors consulted and other specialists, they found these three cases to have been handled with due care.

Levenseindekliniek, NTR, 15 February 2016 https://www.2doc.nl/documentaires/2016/02/delevenseindekliniek.html