Then, after seven years, the cancer suddenly turned aggressive and the treatment no longer worked. The disease had soon wrought havoc among the leukocytes, the white blood cells that guard against infection, and all of Mathilde’s resistance had gone. It was just a matter of time — a couple of weeks or maybe months — before she would die from influenza or some other common infection. At the hospital, they gave her a blood transfusion and told her to report next week; and then they gave her another blood transfusion and told her to report again a week later. And if she had not fallen ill and refused further treatment, they would no doubt have continued in this way.
But we live in the Netherlands, and here is where our story becomes a little different. When people become as ill as my wife, with no prospect of cure and only pain and exhaustion in the offing, it is quite legal to end one’s life by voluntary euthanasia.
For all her quiet ways, Mathilde was a strong-willed person, cherishing her independence and her freedom, and determined to live her life as she wanted. When euthanasia first became a public issue in the early 1970s, she became a strong supporter of the cause. We joined the Dutch Association for Voluntary Euthanasia, signed petitions and wrote letters to members of Parliament demanding such a law. When, as a first step, our courts set out conditions that made euthanasia acceptable, Mathilde, then only in her 40s, made sure we filled out the forms with the association stating that we wanted to receive euthanasia when the time came.
In 2001, euthanasia finally was fully legalized. Those who wanted it had to ensure the cooperation of their family doctor. We made sure all the doctors who joined our village medical practice knew our wishes, and we always asked whether they would administer euthanasia. As an added precaution, Mathilde continued to carry a thick wad of forms and declarations in her handbag wherever she went, in case of an accident.
All the doctors agreed to our request. They were from a younger generation; it is older doctors, mainly, who are reluctant to administer euthanasia. A few refuse on grounds of principle, others because they just do not wish to become involved. But more than 80 percent of all Dutch family doctors, according to a recent large study, report that they have performed euthanasia at least once, and among the willing doctors the average rate is once every two or three years.