In a nightmare conclusion to a worst-case scenario, a 41-year old Dutch man suffering from chronic alcoholism chose physician-assisted suicide over further treatment for addiction.
After 21 failed stints in rehab, Mark Langedijk sought and received approval to end his life by lethal injection. The procedure was performed in July 2016, marking the first time that a person had ever been euthanized for chronic alcohol addiction.
More than 5,000 people are ruled eligible for euthanasia in the Netherlands each year by government-sanctioned medical authorities for a wide range of debilitating and painful conditions that are presumed to guarantee premature death. But over time, these standards have been compromised and individuals suffering from non-terminal health problems have also received approval for the procedure.
In Langedijk’s case, it was his frustration with failed treatment programs more than his actual health condition that motivated his final surrender to addiction. His suffering was real, but it was the loss of hope that made him give up on living, despite the fact that death was far from imminent.
It is surprising and shocking that medical authorities in the Netherlands supported this attitude. Their behavior represents a clear departure from the Hippocratic Oath and its call to “do no harm.”
But it may reveal a hidden bias about addiction and addiction treatment that could have ramifications for others in the same situation as Langedijk. It appears the euthanasia panel accepted the argument that chronic alcoholism was a hopeless condition and that those suffering from it might, in at least some circumstances, be better off dead.
In reality, death from addiction is a preventable tragedy and medical experts should be expected to know this. Mark Langedijk’s 21 failed trips to rehab were not a sign of hopelessness but the actions of a man desperate for help, and what he needed — and deserved — was a much greater effort to understand why treatment never seemed to work out. What were the psychological blocks or emotional barriers that kept him from truly committing to the rehabilitation process, when it was clear he wanted to overcome his terrible addiction to alcohol?
Addiction treatment specialists know that the lessons taught in rehab often don’t stick the first time, or even the first few times. Every addict’s path to wellness is unique and filled with potholes that obstruct the journey. But the journey can and should continue regardless of how long it takes to complete.
Climbing from the Depths of Addiction to the Top of the Mountain
In the United States, six states have now legalized a practice referred to as “medical aid in dying.” Not to be confused with physician-assisted suicide, medical aid in dying provisions grant terminally ill patients with less than six months to live the right to ask for medication that may end their lives prematurely. This is quite a bit different from the Dutch law, which allows more aggressive suicidal actions and created a slippery slope where euthanizing an alcoholic who needed treatment was somehow judged to be a sensible option.
As long as U.S. laws are enforced correctly, something like this should never happen here. But we must acknowledge that Langedijk’s despair and sense of hopelessness are shared by many people with substance abuse problems, here and everywhere across the globe.
As many as 7% of alcoholics in the United States will take their own lives in any given year, and research has revealed that about one-third of all suicide victims met the criteria for an alcohol use disorder at the time of their death. We may see what happened in the Netherlands as a senseless and preventable tragedy, but millions of similarly preventable tragedies are happening right here, without the assistance of a physician but with the same results.
Relapse following treatment is common with addiction, and many people make multiple trips to rehab without achieving lasting results. But there are untold numbers of addicts who found sobriety after years of battling their conditions, and after being in and out of rehab so many times their loved ones gave up on them. Regardless of the depth and intensity of their struggle, it is never too late for an alcoholic or a drug addict to get help for their chemical dependency.
With addiction, there is always hope for healing. Giving up that hope is the one and only thing that will guarantee a tragic ending.