138 people with psychological problems in the Netherlands received euthanasia in 2023. Yvonne Lameijer from Leeuwarden was one of them. Nynke Dijkema, the psychiatrist who performed it, speaks in a documentary series about this. “I actually thought it was very nice, but you do kill someone.”
The relief can be read from her face when Yvonne van Dijkema is told that her euthanasia can go ahead. “Finally I know where things are going, finally I have a goal: to die,” she says, almost beaming, to her psychiatrist.
Dijkema has had the 57-year-old woman in her practice in Leeuwarden for about four years. She suffers from depression and has PTSD. “And she dissociated: she sometimes became a different person and could say very angry things, also to me. Many of her treatment contacts went wrong. We had good contact.”
The woman came to her to find a suitable treatment for her PTSD, but that also failed. “In fact, everything we tried, every treatment, went wrong. Yvonne didn’t want to anymore. She had thoughts of suicide from an early age.”
Waiting periods of two years
So Dijkema reported her to the end-of-life clinic in The Hague. This ‘Euthanasia Expertise Center’ guides doctors in the euthanasia processes of their patients and provides care to those seeking help who do not receive cooperation from their own practitioner. “But the waiting times for people with a mental illness are up to two years. Too long for Yvonne.”
A nurse pointed out to Dijkema that she, as a psychiatrist, could also provide euthanasia. “I thought: wow, that’s really intense. But I realized I could do this as a form of treatment.”
It was the first time in her career that Dijkema was so directly involved in a euthanasia process. “When I was still in training, I once guided a young woman who was suffering so much that she wanted to die. I thought that was very bad. She basically had everything in my eyes. She was eventually given euthanasia through the end-of-life clinic. I was invited to her farewell. Her mother was very happy that her suffering had ended.”
Woman my age
She provided a ‘second opinion’ three times for the end-of-life clinic: one of the conditions for a euthanasia process. “One time it involved a woman my age. She had autism and couldn’t cope with life. I understood that. I remember the look in her eyes, that she was not in the here and now. The news that she had passed away touched me.”
Telling Yvonne’s story also makes Dijkema emotional. “It almost makes me cry. Actually I thought it was very nice. She was so very happy that I was going to do it, but you do kill someone.”
The psychiatrist also found it exciting. “I thought: what if it doesn’t work? That something is not going well in the procedure? I was going to do something I had never done before.” She asked for help from the end-of-life clinic, and says she received very good guidance through all the steps. “You must demonstrate that all possible treatments have been tried, that there is unbearable suffering. Create and request a prescription for the medication, go to the pharmacy to pick it up.”
Five syringes on the dining table
The documentary shows how Dijkema displays the five (!) syringes on her dining table and watches them together with her daughter. The pharmacy numbered them. The actual euthanasia, which is not shown, takes place in Yvonne’s living room, in the presence of her sons. “An ambulance nurse inserted the IV, and then it went very quickly.”
How does she look back on it now? “Very positive, nothing went wrong.” The committee that tested the process afterwards also came to that conclusion.
The waiting times at the end-of-life clinic could be reduced if people who suffer psychologically and want euthanasia can go to their own practitioner, the documentary shows. Dijkema agrees.
Psychiatrist training
“Many psychiatrists now say ‘no’. And of course you can only do this if you support it, not everyone is suitable for it, but we must be open to it.” The possibility of euthanasia should be discussed more in the training of psychiatrists, she says.
“Nowadays there are so many people who get stuck in their treatment, are so damaged that they no longer see any prospects. Of course you should try other things first, but if nothing works, recognize that this is an option. Now we all find it scary.”
Another client recently asked Dijkema: if things really don’t work out anymore, would you like to do a euthanasia process with me? She answered with a resounding ‘yes’. “Of course I want to do that with you, because I know you.”
Documentary maker Elena Lindemans investigates euthanasia in psychiatry
The documentary series ‘A good death’ was made by Elena Lindemans, who grew up in Jubbega. For years her mother suffered from serious psychological problems. She wanted to die, but her euthanasia request was rejected. Since no one helped her, she saw no other way out than to do it herself. On Monday, February 25, 2002, she jumped from the Muntflat in Heerenveen. Lindemans made a documentary about it: ‘Mothers don’t jump from flats’ (2014) which led to a hearing in the House of Representatives at the time.
More than twenty years later, she investigated whether anything has changed in care to people who suffer mentally and have an expressed wish to die. Are they being heard now?
Lindemans: “Since 2012 we have had the End of Life Clinic in the Netherlands, now called the Euthanasia Expertise Center. That jumped into this hole, with the idea of dissolving itself if the foundation became redundant after a number of years. But the center became indispensable. The waiting time has now increased from a few months to two years.”
Don’t immediately shoot reflexively
In 2023, 138 people with psychological suffering received euthanasia; half by the expertise center, the other half by your own GP or psychiatrist. Lindemans: “There seems to be a slight change, that is hopeful. But the majority of psychiatrists still believe that it is not part of their job. That’s why I think it’s so great that Nynke Dijkema realizes with Yvonne: I can’t send her on, she won’t make it, I’ll do it myself.”
In the series ‘A good death’, the literal translation of the ancient Greek word ‘euthanasia’, she follows six people who no longer want to suffer due to psychological problems and ask for euthanasia. She also follows doctors and psychiatrists who sometimes face major dilemmas. Lindemans: “I hope that the series encourages them to think a little longer about a euthanasia request, and that they do not immediately react to the reflex: I do not do euthanasia, just go to the expertise center. ”
The documentary maker, who filmed for two years, saw with some main characters the relief and joy when they were allowed to end their lives humanely with the help of a doctor. ,, That was sometimes a strange sensation. I saw people, as death got closer, beaming because they didn’t have to commit suicide now.”
The four-part ‘A good death’ is from Monday, May 6th weekly at 10:10 PM can be seen at BNNVARA on NPO 2 .
Tags: Mentally ill Yvonne wanted die psychiatrist Nynke Dijkema gave euthanasia
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