Dutch people are being euthanized for having autism

By James Schadenberg

The Associated Press published an article on June 28 (Link) about a worrying trend in the Netherlands where people with disabilities such as autism are being killed through euthanasia on the basis that they claim they cannot lead normal lives:

Tine Nys died by euthanasia based on autism

Several people with autism and intellectual disabilities have been legally euthanized in the Netherlands in recent years because they said they could not lead normal lives, researchers have found.

The cases included five people younger than 30 who cited autism as either the only reason or a major contributing factor for euthanasia, setting an uneasy precedent that some experts say stretches the limits of what the law originally intended.

In 2002, the Netherlands became the first country to allow doctors to kill patients at their request if they met strict requirements, including having an incurable illness causing “unbearable” physical or mental suffering.

These findings were uncovered in a study by Irene Tuffrey-Wijne, a palliative care specialist at Britain’s Kingston University. By reviewing 900 case files from the years 2012-2021, which were publically posted by the Dutch government’s euthanasia review committee, they noted that 39 of these case files involved autistic and/or intellectually disabled individuals, with over half of them being younger than 50.

As Irene Tuffrey-Wijne points out, this sends a disturbing message that death is a solution to feelings of loneliness and social alienation:

Many of the patients cited different combinations of mental problems, physical ailments, diseases or aging-related difficulties as reasons for seeking euthanasia. Thirty included being lonely as one the causes of their unbearable pain. Eight said the only causes of their suffering were factors linked to their intellectual disability or autism — social isolation, a lack of coping strategies or an inability to adjust their thinking.

“There’s no doubt in my mind these people were suffering,” Tuffrey-Wijne said. “But is society really OK with sending this message, that there’s no other way to help them and it’s just better to be dead?”

The article illustrates some of the cases of autistic people who were approved of euthanasia that the researchers were looking at:

Among the eight patients cited by researchers were an autistic man in his 20s. His record said “the patient had felt unhappy since childhood,” was regularly bullied and “longed for social contacts but was unable to connect with others.” The man, who was not named, chose euthanasia after deciding that “having to live on this way for years was an abomination.”

The records also included an autistic woman in her 30s who also had borderline personality disorder. She was offered a spot in a supported living center, but her doctors said she could not maintain relationships and deemed contact with others “too difficult.”

In one-third of cases, Dutch doctors concluded autism and intellectual disabilities were untreatable and that there was “no prospect of improvement,” the researchers wrote.

This research has been met by experts condemning this aspect of the Netherlands’ euthanasia regime:

Simon Baron-Cohen, director of Cambridge University’s Autism Research Centre, said it was “abhorrent” that people with autism were being euthanized without being offered further support.

He noted that many autistic people struggle with depression, which could compromise their ability to make a lawful request to die. He also said an autistic person asking to die might not grasp the complexity of the situation.

Dr. Bram Sizoo, a Dutch psychiatrist, was disturbed that young people with autism viewed euthanasia as a viable solution.

“Some of them are almost excited at the prospect of death,” Sizoo said. “They think this will be the end of their problems and the end of their family’s problems.”

A representative of the Royal Dutch Medical Association said it was up to doctors to decide if someone meets the criteria for euthanasia. The group said many cases involving patients with autism were “highly complex” and that “age itself is not a decisive factor to determine whether a person suffers unbearably.”

Kasper Raus, an ethicist and public health professor at Belgium’s Ghent University, said the kinds of people seeking euthanasia in both the Netherlands and Belgium have shifted in the past two decades. When euthanasia was legalized, he said, the debate was about people with cancer, not people with autism.

Another expert quoted in the article wonders whether this could be happening in Canada as well:

Tim Stainton, director of the Canadian Institute for Inclusion and Citizenship at the University of British Columbia, wonders if the same thing is happening in Canada, which arguably has the world’s most permissive euthanasia laws and which doesn’t keep the kinds of records that the Netherlands does.

“Helping people with autism and intellectual disabilities to die is essentially eugenics,” Stainton said.

Much of the underlying philosophy of the “right-to-die” movement is that death is preferable to suffering. The research done by Irene Tuffrey-Wijne shows where this philosophy leads. These people needed someone to talk to, someone to spend time with, and societal acceptance. They needed love and acceptance but were given death instead.

Tim Stainton is right to point out that because the Netherlands keeps records of controversial euthanasia cases and Canada does not, we cannot know if people who have mental disabilities like autism are at a similar risk of being killed by Canada’s euthanasia regime. Even if we did keep such records, it would be up to the doctors to make these records in the first place. Canada, as well as the Netherlands, needs to move away from a system where doctors self-report details surrounding euthanasia cases so that we can have more accountability in the system.

Further reading:

• A record number of euthanasia Netherlands deaths in 2022. 288 dementia euthanasia deaths. (Article Link).
• Dutch doctors approve euthanasia for incompetent people (Article Link).
• Study examines euthanasia for people with intellectual disabilities in the Netherlands (Article Link).