October 15, 2023

Pyschiatric Illness & the Young in the Netherlands

Just before his death last Wednesday, 31-year old Dutchman David Mulder, made one last emergency appeal: lower the threshold to die for people with unbearable mental suffering.

Dutch TV program, Khalid & Sophie, broadcast David’s last interview, the day before he died.

“I am in distress,” Mulder said at an otherwise empty talk show table at Khalid & Sophie.

More and more people are choosing and obtaining consent for euthanasia, figures from the Regional Euthanasia Review Committees showed last year.

Yet the threshold for euthanasia in cases of unbearable psychological suffering is still too high, Mulder believes.

Too desperate to wait for euthanasia

“There are too few doctors who can or want to perform it, the waiting list at the euthanasia centre of expertise is over two years. You are not eligible for euthanasia until you have had the whole process.

By then you are already so far gone and so desperate, often you don’t have two years left,” he explained to Sophie.

Mulder himself was also on a long waiting list.

Wanting to die earlier, he initially opted for an alternative death. “That was actually the reason why I would stop eating and drinking,” he says.

Mulder tells in Khalid and Sophie about life full of depression

Mulder told his story in Khalid & Sophie after an extensive interview with daily newspaper the Stentor.

For as long as he can remember, he has struggled with severe depression and was the youngest child ever to be prescribed antidepressants.

“I constantly have a kind of uncanny feeling inside: I don’t want to be in this world,” he says.

He cannot enjoy it, he says. “That for me is temporary distraction from that keynote of suicidal thoughts that are always there.”

Love for his wife

Also present in Khalid & Sophie’s studio are his parents and his wife Mariël.

Whether he had hopes that the great love for his wife would help him get rid of depression? “I never had that illusion,” he responds calmly.

“But if I hadn’t met her, I would have been long gone. She is and was a huge motivator to continue with all those therapies anyway and keep fighting. My death wish is separate from my love for her.”

For as paradoxical as it is, he does not want to die, he says. “Nobody wants to die. I don’t want this way of life anymore.”

Treated out after years of therapy

After years of therapies and admissions, Mulder is out of treatment. But because his GP and psychiatrist cannot or will not perform euthanasia on him, he ended up on a waiting list. This has to change, he believes.

The debate surrounding an end to life due to psychological suffering, emerged much later than that surrounding physical suffering.

Few psychiatrists dare or can answer that question and so people end up on the waiting list at the Euthanasia Expertise Centre, psychiatrist Menno Oosterhoff tells Khalid & Sophie.

‘No reasonable bright spots’

Helping people die is a “very complicated step” as a psychiatrist, Oosterhoff argues. “In my profession, wanting to die is a symptom that you very often try to treat. So you spend a lot of time trying to see points of light in the darkness.

To then recognise that there are no reasonable bright spots left, that certainly requires a switch. But it has to come,” Oosterhoff believes.

“People can feel so hugely let down,” he stresses.

“First, because the Euthanasia Expertise Centre cannot cope with it all. There are inhumanly long waiting lists. And it needs to be discussed in our profession at all.

We need to see that wanting to die is not always a consequence of your illness, but a very understandable, understandable wish.”

Relief

In the end, Oosterhoff chose to perform euthanasia on David, sparing him the agony of ‘dying’, as stopping eating and drinking is called.

It was also a great relief for his parents, they say. “I want to be able to say goodbye,” his father says emotionally on Khalid & Sophie.

Dying was a horrible alternative, says his mother.

“He wants to die with dignity. But we were going to watch our son starve, have to take care of him, support Mariel.

We would have done it. But it hung over our heads like a concrete block.”