It turned out that in most countries the citizens are far ahead in their thinking about the end of life compared to the politicians, church hierarchy and medical associations. Each of these groups have their own interpretation of the matter. But it comes to the same fact that the wish of the people are not only perceived but just neglected.

In the Netherlands it took more than 30 years to acquire a euthanasia law (2002) as the codification of case law provoked by courageous physicians who reported their euthanasia to the public prosecutor. The due care criteria were formulated in seven case law procedures, the first one took place in 1973.
In Belgium and Luxemburg the law came about in a different way but with nearly the same outcome.
At the end of the thirties in Switzerland a law was adopted to make assisted suicide legal.
The big difference between Benelux and Switzerland is that the Benelux does not allow what is called ‘euthanasia tourism’.

A short historical overview:

The World Medical Association (WMA) (1981 revised in 2015) postulated in Portugal ‘the Declaration of Lisbon on the rights of the patient’.
In Article 10 c we read: ‘the patient is entitled to humane terminal care and to be provided with all available assistance in making dying as dignified and comfortable as possible’.
This is liable for different explanations.
In the code of medical ethics WMA (1949 revised in 2006) and adopted in ‘Duties of physicians to patients’: a physician act in the best interest when providing medical care. In my idea this can also involve providing the last medication on request of the patient.
But in 2005, and revised in 2015, the WMA adopted the Declaration on euthanasia: Euthanasia, that is the act of deliberately ending the life of a patient, even at the patient’s own request or at the request of close relatives, is unethical. This does not prevent the physician from respecting the desire of a patient to allow the natural process of death to follow its course in the terminal phase of sickness.
Without a doubt it is unethical when the physician does provide the lethal medication on request of close relatives and not on request of the patient!
The patient is in Switzerland and the Benelux the one who asks for the lethal medication and not the relatives fortunately!

As luck would have it, there will always be compassionate physicians who don’t let their suffering patients down in the end and bid them a dignified death.

Right to Die Europe (RtDE), founded in 1993, wants to coordinate and support European societies dealing with end-of-life issues. These can consist of euthanasia, medical help in dying, assisted suicide or promoting a living will. In a living will a person is able to lay down her/his wishes about medical treatment. Each society has to act according to the situation in their country. It is not possible to copy one to one the situation in Switzerland and the Benelux.

What are the ambitions or bits and pieces of RtDE?

1. To seek acceptance and legislation of voluntary euthanasia, assisted suicide, at least medical help in dying.
2. To encourage the discussion on ending life in dignity.
3. To campaign for the legal acceptance of the living will, advanced directives.
4. To seek social acceptance and legal recognition in Europe of self-determination to guarantee a dignified death.
5. To support initiatives towards setting-up Right to Die Societies.
6. To strengthen the ties between the European Sister Societies.
7. To make every effort to be represented at appropriate European or national organisations.
8. To oppose those who wish to deny self-determination at the end-of-life.

In 1984 the World Federation of Right to Die Societies (WFRtDS / WF) was founded with member societies on all continents. At the WF conference in Kyoto in 1992 we discussed the idea of founding regional societies under the umbrella of WFRtDS.
At a meeting in Paris early 1993 the European members of WFRtDS decided to come to an European sub-division. In May 1993 with the help of the NVVE we founded the RtDE in Bergen aan Zee, a lot of societies were represented. The intention and the idea was that we could become stronger in our discussion with authorities, national and international. To start with applying for a INGO status at the Council of Europe in order to propagate our ideas at an higher level in Europe. Unfortunately the European initiative was not followed on the other continents

But indeed, after 10 years of hard work we achieved our INGO (International Non-Governmental Organization) status at the council of Europe in 2013. Our application was several times rejected with the argument that we were too controversial. At last we succeeded in our ambition. The treasurer Hugh Wynne and I attend twice a year the INGO meetings in Strasbourg. The aim to be part of the INGO’s was that in this international body recommendations are prepared for the Council of Europe about important matters. Our intention is to join forces with a number of INGO’s that support our ideas in order to bring forth a proposal to be put on the agenda. We already met several representatives of organizations in favour for what we stand for, but with another point of view and striving for their own goal. Still they are not against us although it is not their first priority. In our corridor chats in the ‘arena’ we found out that our way of thinking is not that controversial for a lot of INGO’s with different backgrounds. For instance: The Humanists, APT (Association to prevent torture) and the League for gender equality.

In total there are 220 INGO’s connected to the Council of Europe (CoE) with a great variation of interests, countries, religions and politic systems.

The council of Europe and the European Union: two organizations that promote peace and human rights.

The Council of Europe works together with its 47 member states including the 28 members of the EU to strengthen human rights and democracy across the continent and beyond.
The EU brings its member states closer together, both economically and politically, by harmonizing legislation and practices in certain policy areas.
The council and the European Union work together to strengthen democracy and human rights wherever necessary in Europe. Major programs and substantial levels of financial resources are implemented jointly in these areas.

Actions:

The Council of Europe:

Drafts conventions and establishes legal standards for its member states
It verifies how they are implemented and develops programmes to help governments honour their commitments.
The judgements handed down by the European Court of Human Rights (ECHR) are binding on the countries concerned. Hey have obliged governments to amend legislation and administrative practice in many fields.

The several working institutions are:
The European Court of Human Rights oversees the implementation of the European Convention on Human Rights in the member states
The Secretary General leads and represents the Council of Europe.
The Committee of Ministers, made up of member states’ foreign ministers and their representatives, acts as the main decision-making body.
The Parliamentary Assembly (PACE) with its 318 members, they meet 4 times a year, elects the Secretary General, the Human Rights Commissioner and the judges to the European Court of Human Rights. It provides a democratic forum for debate and monitors elections and its committee play an important role in examining current issues.
The Human Rights Commissioner independently addresses and brings attention to human rights violations.
The Congress of Local and Regional Authorities is responsible for the strengthening local and regional democracy. It comprises 636 elected local and regional authorities.
The Conference of International Non-Governmental Organisations represents civil society and promotes participatory democracy.

In the conferences of INGO’s advices are prepared and after adoption brought to the Council for adoption and implementing. We do hope that I due course we can draw an advice and present that in the INGO conference to be adopted and sent to the Council about end-of-life.

The driving force of the Council of Europe is the Parliamentary Assembly (PACE).
The 318 parliamentarians come from the national parliaments of the Organisation’s 47 member states.
The texts adopted by PACE- recommendations, resolutions, and opinions-serve as guidelines for the Committee of Ministers, national governments, parliaments and political parties.
It will take a long time before you are aware how to find your way in this bureaucratic labyrinth as was told by some experts. They advised to appoint a lobbyist, but this is only possible when an organisation has a huge budget.

The Council of Europe has it’s headquarter in Strasbourg, France. It employs 2200 people, and maintains external and liaison offices in other international organisations. The budget is € 403 million, and is financed mainly by the member states.

The European Union:

Drafts European laws, negotiates trade and provides funding for various projects.
It has established an economic and monetary union, forming a free trade area with a single currency (the euro).
Has the exclusive powers, in particular in the economic field, which means that states have delegated some of their sovereignty.

In this megalomania we have to find our way and I do hope that we are able to, as a part of human right, get the human right to decide how and when to end your life in dignity on the agenda.

With your help and support it is worthwhile to attempt to change the negative mood in Europe and in most countries by informing us what is going on in your society and country. The rationale of RtDE is to fight mutually for the freedom to choose at the end-of-life how and when.
You have to come with proposals and should not wait till we propose ideas because we are not aware of the problems you meet.
If we all know the bottlenecks you run across we can use each other’s experience to face the problems more self-confidently, I do hope.

-I love to quote Jacque Pohier (1998), who pointed forward that voluntary euthanasia is not a choice between life and death but the choice between two kinds of dying.

-Another quote: people don’t really want to die, but they cannot live any longer, they just want to end their suffering.

-Talking about euthanasia is often more important than the deed itself.

It’s amazing to see that patients who know that they will be helped in the end do live longer and often die the natural way or in other words they pass away in dignity. They are no longer afraid for the end and can concentrate themselves on their leave.

There is at the moment worldwide a discussion going on how to die in dignity by yourself. Appropriate medication is no longer available unless you know addresses elsewhere.
The ‘Helium method’ is no longer reliable because helium bottles may contain a mixture of gases OK for balloons but probable no longer useful for self-deliverance. There is a search for other gases but those are more difficult to handle for frail persons at the end-of-life.

At the NuTech meeting this summer many ways where suggested other ways of self-deliverance the concepts continue to be delivered by mail. If you see all the advised thinkable solutions you cannot image that it has something to do with a dignified death. Desperate fellow human beings who are not heard about their wish to end their life may use horrifying procedures such as guns, a rope, an apartment building, transportation devises and drowning. This kind of termination of life c.q. suicide is devastating for the person and the bystanders and the next of kin. As far as I could trail the data it’s far more than the few people who die in dignity by euthanasia or physicians assisted death.
In my opinion we must scrutinise this procedures and show them to the opponents, for instance the lawmakers, what they bring about not accepting the fact that competent people have to go through to die. It is merciless that opponents to hold back a dignified death with the idea of what they call ‘Slippery Slope’.
As I quoted before people want to live but sometimes life can an unbearable burden and a dignified death is benevolent.

We should show our opponents the inhumane procedures to convince them that for the few who want to die in dignity it is a normal human right.
It is misunderstanding that when euthanasia or physician assisted death is legal it will become an obligation for others, freedom to choose.