A longtime politician with conservative roots but who campaigned for many liberal causes, van Agt was the prime minister of the Netherlands from 1977 to 1982. He later became the ambassador of the European Union to Japan and the United States.
Photos of the couple from their decades-long careers as public figures often show them walking in step: waving to a crowd through a car window, voting together at a polling station and giving each other a smooch at a public event.
Van Agts’ health had declined in recent years, Dutch public broadcaster NOS said. The former prime minister never recovered after suffering a brain hemorrhage in 2019, which occurred while he was delivering a speech at a commemoration event for Palestinians. Eugenie’s health issues were largely kept private.
“I feel it’s good, honestly, that you’ve spent your lives together, that you both happen to be very sick with no chance of getting better, you’re ready to go, and you would like to join,” said Maria Carpiac, director of the gerontology program at California State University at Long Beach.
When it comes to the right to choose one’s own death, the Netherlands is “kind of a model” for any US legislation on the subject, she said.
At least 29 couples – or 58 people – died together through duo euthanasia in 2022, the latest year of data from the country’s Regional Euthanasia Review Committees. That’s more than double the 13 couples who did so in 2020, when the committee began looking specifically at partners, but it still represents only a small fraction of the 8,720 people who died legally euthanasia or assisted suicide in the Netherlands that year.
“It looks like this will happen more and more often,” said Rob Edens, press officer for NVVE, a Dutch organization focused on research, lobbying and education about assisted suicide and euthanasia in the Netherlands. “We continue to see that doctors are willing to provide euthanasia based on a cluster of age-related conditions. But it is allowed” in the country’s legal guidelines, he said in an email.
Assisted suicide is when a person self-administers a lethal dose while a physician is present, and euthanasia is when a medical professional administers the dose. Both are legal in the Netherlands when certain criteria are met. (Some groups prefer the term “medical assistance in dying,” or MAID, because of the religious and social stigma surrounding suicide.)
Euthanasia is illegal in the United States, but assisted suicide is allowed in DC and at least 10 states: Oregon, Washington, Montana, Vermont, California, Colorado, Hawaii, New Jersey, Maine and New Mexico. Eligibility requirements tend to be strict across the country, Carpiac said, but there are differences between jurisdictions.
6 steps to end-of-life planning
The Netherlands, a country of almost 18 million people, has allowed assisted suicide and euthanasia since 2002. It requires individuals to be willing to end their lives in a way that is “well considered,” with a doctor’s approval that they are suffering “unbearable suffering with no hope of improvement.”
Another physician must then agree that the person is eligible, and doctors can choose whether to participate in the procedure. After every death, doctors must contact a regional review committee, which checks whether each case was handled legally. Couples seeking duo euthanasia must apply and go through a review process on their own, with separate doctors.
“The accumulation of age-related complaints can lead to unbearable and hopeless suffering,” Edens said, explaining the Dutch guidelines. “The expectation is that if doctors are increasingly willing to provide euthanasia when there is a collection of complaints of old age, the number of euthanasia duo. [cases] it will increase.”
Research shows that older Americans are at increased risk of dying after losing a spouse, especially in the first few months after the death. Although the cause of this phenomenon is unclear, studies have found that depressed participants have higher levels of inflammation and are at increased risk of heart attack and stroke, often due to changes caused by with stress in blood pressure, heart rate and blood pressure.
“The first thing that came to mind was the widow effect,” Carpiac said, referring to van Agts’ choice to die by euthanasia duo. “I have a grandmother who is 96, and she’s like, ‘I’m not going anywhere!’ But if I had a partner and they were my personality, and we were both at the end of our lives, would it be worth it if he went without me? Would I die with what I considered a broken heart? I’d like to have a choice.”