Preparing for D-day

By Harry van Versendaal

It was 1995 when Juul Bovenberg’s father became seriously ill. After a short but painful spell on his sickbed, Mr Bovenberg asked his GP to take away his suffering by taking away his life. The family and the doctor agreed to the man’s final wish to choose a dignified death over endless, unavoidable pain.

When the GP visited the house to carry out the euthanasia, for once Bovenberg’s attention was not focused on her ill father. In fact, the 23-year-old Juul could not help stare at the man who had come to end her father’s life.

“I noticed how nervous he was. His whole body was shivering, and I saw his relief after he was done. As his car left the driveway, I realized how difficult this must have been for him. He was the one to actually pull the trigger. I asked myself: How will he return home; what does he feel right now?” she explains now.

But it would be years before Bovenberg, a Dutch filmmaker in her late 30s, would begin to search for an answer. In 2009, she made a documentary inspired by that incident. “A Deadly Dilemma: Euthanasia from a Doctor’s Perspective” – which was screened last week at the 2nd International Health Film Festival on Kos – follows three Dutch GPs during each of their preparations for and the sequel to performing euthanasia on one of their patients. The movie, which won the jury’s second prize for medium-length films, came after last year’s screening of John Zaritsky’s “The Suicide Tourist,” a compelling documentary about an American Amyotrophic lateral sclerosis (ALS) patient’s decision to make use of assisted suicide in a Swiss clinic.

Voluntary euthanasia has been legal in the Netherlands since 2002. Doctors are allowed to help terminally ill patients to die, provided they follow a set of strict regulations designed to prevent abuse. Patients must be terminally ill adults facing a future of “unbearable” suffering. They must have made a voluntary, considered and persistent request to die, while a second, independent physician must give the green light before the procedure is carried out. Holland was one of the first countries to legalize mercy killing, although the practice had been unofficially tolerated for decades.

Voluntary euthanasia and/or assisted suicide, which has also been legalized in Belgium, Luxemburg, Switzerland and the US states of Oregon and Washington, is still very much the subject of controversy involving moral, medical, religious and philosophical questions. Notwithstanding the title of Bovenberg’s documentary, the doctors featuring in it seem to have no second thoughts about the ethics of the practice. What they do seem to carry is the mammoth emotional burden about being the ones to shut down the circuit. “You are not trained to kill someone,” one of them says in the movie. An ethical decision is not necessarily an easy decision.

“I didn’t want to make a film about the moral aspect of euthanasia,” Bovenberg says. “It is about the feelings of GPs in a country where euthanasia is legal. Even for doctors that morally accept euthanasia, it remains a heavy subject, having to apply it. A lot of people have the wrong idea about euthanasia in the Netherlands, as if this does not mean anything to a doctor. But a doctor has feelings too.”

In the movie, we see the doctors holding their regular meetings with their terminally ill patients, discussing with them and their relatives as they regress. The process is emotionally difficult and, in some cases, practically almost impossible. A heavily paralyzed woman suffering from ALS struggles to communicate with the doctor by moving her thumb and, when this becomes impossible, with slight nods of her head. Her husband sits alone in the backyard. The doctor is worried that her rapidly deteriorating patient will soon no longer be able to give her (legally required) consent. In the end, she doesn’t have to, as the woman dies of natural causes.

Another doctor frequents the gym to sweat out his stress. He chats with colleagues and takes care of “normal” patients. And then comes D-day. He prepares the lethal potion. Driving his car to the house of his patient, a shockingly calm and cool-headed man suffering from a hereditary metabolic disease, the poison sitting in a brown bag on the back seat, he wonders about his patient’s feelings about physical contact. “Is he the type to hug and embrace?”

Bovenberg, who lives on a houseboat in Amsterdam, studied documentary and production at the Dutch Film and Television Academy (NFTVA) in Amsterdam. She is the winner of the prestigious Nipkowschijf award for the VPRO Dutch television series “Veldpost.” Her “Looking for Loedertje” was nominated for the Dutch Academy Award while “Laura is my Father” was nominated at the Cinekid Festival. “A Deadly Dilemma” is her twelfth movie.

“Why do you do it?” the director asks the third doctor, who is preparing to end the life of a young woman who has cancer. “In the end, because of my love for my patients,” he replies.

Ultimately, they all feel they have done the right thing; they all feel relieved. But don’t get the wrong impression. “You never get used to it. It’s the hardest thing to do.”

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