"I'm 29 years old and I've chosen to be voluntarily euthanised. I've chosen this because I have a lot of mental health issues. I suffer unbearably and hopelessly. Every breath I take is torture…"
After a long legal battle, including repeated assessments by psychiatrists who opposed her decision to commit suicide, Aurelia Brouwers was finally allowed to end her life in an assisted suicide on January 26 of this year.
While assisted suicide is legal in the Netherlands where Brouwers lived, almost all of the 6,585 euthanasia deaths occurring there in 2017 were of people suffering from terminal diseases. But 83 of those deaths were, like Brouwers, suffering from mental disorders which was non-terminal in nature.
Under Dutch law, assisted suicide can only be approved if a medical doctor certifies that the applicant's life "unbearable with no prospect of improvement" and that there is "no reasonable alternative in the patient's situation." In Aurelia Brouwers' case, her request for euthanasia was repeatedly denied by her medical doctors. This led her to appeal the decision to the Levenseindekliniek - the End of Life Clinic - in The Hague. Not only is this clinic the place of last resort for people whose request for euthanasia was denied by other doctors, but it was also where 65 of the 83 deaths approved for euthanasia due to incurable mental illness were carried out.
Once final approval was received, Aurelia Brouwers became the subject of considerable media attention. For the last two weeks of her life, she was followed by a television news crew as part of a planned documentary on her case. This meant recording scenes in which she made peace with family members, rode her bicycle through the town where she lived, and even as she planned her funeral. It also included following her as she visited the crematorium she had chosen for the final disposition of her remains and as she marked off each day she had left on a whiteboard in her home.
She showed no reluctance as she described her decision to die. "When I was 12, I suffered from depression. And when I was first diagnosed, they told me I had Borderline Personality Disorder," she said in a final media interview. "Other diagnoses followed - attachment disorder, chronic depression, I'm chronically suicidal, I have anxiety, psychoses, and I hear voices...."I'm stuck in my own body, my own head, and I just want to be free. I have never been happy - I don't know the concept of happiness." She also acknowledged making numerous suicide attempts on her own. "I think I tried about 20 times. I was critical a few times, but I often got to hear that my heart and lungs were so healthy. The doctors said, 'It's a miracle, she made it."
And the people around her had no difficulty seeing that she was in pain. Sander Paulus, the RTL Nieuws journalist who spent much of her last two weeks with her didn't hesitate to describe her as troubled. "She was really not as stable during the day," Paulus said. "You just felt there was a lot of pressure in her head. She didn't speak that well any more - except when we talked about euthanasia. She was very clear on that."
When her final day came, she simply drank the lethal combination of medications given to her by her doctor and lay down to die. But the legal turmoil of her case continues to provoke debate in the Netherlands. Even though Dutch law allows for euthanasia so long as the patient's decision to die is "voluntary and well-considered," many psychiatrists fiercely oppose extending this same right to the mentally ill. Doctor Frank Koerselman, a psychiatrist who is one of the leaders of the movement against euthanasia for mental patients, insists that psychiatrists should never comply with a patient's desire to die.
"How could I know - how could anybody know - that her death wish was not a sign of her psychiatric disease?", Dr. Koerselman asked recently. "The fact that one can rationalise about it, does not mean it's not a sign of the disease," says Dr Koerselman says. He also adds that psychiatrists working with these patients play a special role in keeping patients alive, "It is possible not to be contaminated by their lack of hope. These patients lost hope, but you can stay beside them and give them hope. And you can let them know that you will never give up on them."
Though Aurelia's struggle is over, the controversy she leaves behind will linger much longer. Who can say if this is the legacy she wanted?