The Last Days of Annie Bus: A Chronicle of Dutch Euthanasia

Published on Spiegel Online International, by Laura Höflinger, Feb 4, 2015, (Photo Gallery).

Annie Bus of the Netherlands suffered from horrendous pain and paralysis, but not from a terminal illness. She wanted to die anyway. The story of how she got her wish demonstrates how difficult it is to set boundaries in a country that permits assisted suicide.  

  • Constance de Vries sits in the kitchen and fills two syringes. She fills one with a strong anesthetic and the other with poison. She slowly dabs the excess liquid from the needle with a tissue before cautiously packing it up. Then she heads out to her car. At 2 p.m., Annie Bus is scheduled to die.
  • The two women have discussed the details of the procedure numerous times. During those conversations, they sat at the wooden table in Annie Bus’ small home, located in the Netherlands just 15 kilometers (9 miles) from the German border. The walls around the table are covered with pictures of Bus’ children and a cross. “Are you certain,” de Vries asked on many occasions, as Bus sat in her electric wheelchair, her legs covered in a knitted blanket, her shoulders crouching slightly to the front as she smiled happily. “Yes, I am certain.”
  • The 75-year-old listened patiently as the doctor explained Dutch euthanasia regulations to her. She would have a choice of drinking a deadly substance or having it administered by injection. The anesthetic would take effect within 10 seconds and, at most, she might yawn before losing consciousness. When the time came for the overdose of muscle relaxants, which would paralyze her respiratory system, she wouldn’t feel a thing.
  • Bus fidgets in her wheelchair. She likes the sound of not feeling anything. She says she feels weak, even though she comes across as being very alive. She talks about how she used to dance in bars when she was young, how she became a mother at 24 and a grandmother at 44. Then, her voice falters. She moans quietly and bends forward.

A Life in Agony: … //

… The ‘End of Life’ Clinic: … //
… Fulfilling the Criteria: … //
… Are Lines Blurring? … //
… A Pill for the Last Will: … //
… In Good Times and Bad Times: … //

… Is Better Care the Better Answer?

  • But the fate of Annie Bus is one that will be shared by many who are young today. They will be forced to live in convalescent homes, possibly suffering from dementia and reliant on care. Would it not be the better answer to improve care options rather than sending sufferers to their death?
  • “It’s not a question of good care,” de Vries counters. “What counts is freedom.” She says the people she speaks to don’t want to be placed “behind bars” in nursing homes. They’re people like Alzheimer’s patients who don’t want to do jigsaw puzzles with “the other senile people” and men who don’t want to pee in diapers. They see death as a blessing. Sometimes relatives send de Vries flowers after she performs euthanasia.
  • Annie Bus also yearns for the independence she lost 23 years ago. One morning, shortly before her 54th birthday, she lost all feeling in her legs. She managed two final steps before collapsing to the ground. She cried for help into an empty house and couldn’t reach the phone. Using her arms, she crawled along the floor towards the window and pulled on a curtain.
  • A neighbor noticed the waving material and called the local doctor for help. But it took until evening before a specialist figured out what had happened. Detached tissue had blocked a vein leading to her spinal cord and her nerves had already been damaged by the time the doctor could act.

It Just Isn’t Fair:

  • Bus remains convinced to this very day that her legs could have been saved. However, it’s more probable that her fate was determined within a matter of seconds. With great effort, she sits up in bed. “If something like that happens to you at 75, it’s terrible,” she says. “But if it happens to you at 54, it just isn’t fair.”
  • “Our mother never accepted her fate,” says one of her three daughters, as the others nod in agreement. Once they knew their mother was going to die, they began visiting her every day. Today they’ve cooked beef soup together. The youngest daughter reads a poem. They stay together and reminisce about the person their mother used to be.
  • In earlier days, before the accident, she used to ride her bicycle everywhere — to consumer electronics company Philips where she had a cleaning job, and to nearby Germany where she sewed shoes. She always worked — and was not the type of person to sit still.
  • She loved Carnival (Mardi Gras). At nights in the bars, their mother would holler out to her daughters to stay, even when it was well past time to go home. “Have another drink!” Then they would dance together on the tables. On the tables? The women laugh. “Oh yes, on the tables!”
  • “We also often went on walks together in the forest at night,” the youngest daughter recalls. Then she starts crying and one of her sisters embraces her.

The Moral Conflict of an Entire Generation:

  • Can they understand that their mother wants to die? “I look at her and, above the chest, everything seems to be OK,” one daughter says. “She says she’s in pain,” another interjects. “But of course we can’t feel it,” says the third.
  • The three women are confronted with the moral conflict of an entire generation: For people like Annie Bus, is death salvation or a terrible mistake?
  • Two days before her death, a retired priest performs last rites. Two other sitting priests had refused to do so, saying that Bus’ wish violates the will of God — and she hasn’t ceased complaining about it since. She spent all of her 75 years as a Catholic and there are four wooden crosses hanging on the walls of her home, but when Bus needed the church’s help, it turned its back on her.
  • The next day, the family watches old videos together. The same day, De Vries celebrates a goodbye party at her practice. It’s her last day as a general practitioner, but she will continue working for the Levendseindekliniek.
  • Then Tuesday arrives. Before noon, an ambulance stops in front of the Bus’ gray brick house. A paramedic connects a cannula to her vein, placing a bandage over the tube. De Vries is out of practice and has asked him to insert the tube so that she can’t accidentally administer the shot in the wrong place. She’s anxious about Bus’ relatives watching and also about the patient’s own fears.
  • At 1:15 p.m., de Vries sits at her dining room table and inserts the needles into ampules. The medicines have been sitting in her refrigerator for a week. She slowly fills the syringes as her two grandchildren watch “Snow White and the Seven Dwarves” on TV nearby.
  • De Vries writes numbers down on the syringes. The first contains a saline solution to rinse the cannula. The second will provide a light anesthetic to numb Bus’ veins before she injects the third containing the full anesthetic. After that step, de Vries will inject the final shot containing 150 milligrams of Rocuronium, which paralyzes the respiratory muscles.
  • She carefully places the syringes in a Tupperware container. “Never show up too early,” she explains in the car. “Otherwise you will disturb the family as they are saying their goodbyes.” There’s an emergency kit in a pharmacy bag on the back seat of the car. “You never know what might happen,” she had said earlier.

Yes, I Am Sure:

  • At 1:45 p.m. the car turns into the small street where Bus lives. De Vries grabs her doctor’s bag, the other bag, the Tupperware container and rings the doorbell.
  • Everyone has come — the daughters, Bus’ husband, the grandchildren and 15 relatives and friends. They circle around her. One of the daughters holds her mother’s hand. Her eyes are red. Bus smiles. So many people have come, just for her.
  • De Vries takes off the bandage so that she can access the cannula. She reaches for the first shot.
  • “Are you sure?” she asks.
  • Yes, I am sure.
  • They lower the backrest on her wheelchair and place a pillow beneath Bus’ head. Her husband moves closer to her and Bus’ second daughter holds tightly onto her mother’s hand. The youngest daughter is sitting at her feet. “Mom, do you still have anything you want to say?” she asks, squeezing her hand.
  • Bus starts to cry as she utters her final words. “I hope that nothing like this ever happens to you.”
  • She says she wants them all to stay together, that she always had things good with them and that they should talk about their problems. Then her tears run dry and her voice grows quieter. De Vries strokes her cheeks.
  • She says she wants them all to stay together, that she always had things good with them and that they should talk about their problems. Then her tears run dry and her voice grows quieter. De Vries strokes her cheeks.
  • At 2 p.m., the bells chime on the wall clock, but the crying of the family drowns out the sound. Annie Bus feels nothing.

(full text).


Update 10.30 MEZ – about the Munich Security Conference:

Sending weapons to Ukraine would escalate violence – UK Defence Secretary, on Russia Today RT, Feb 6, 2015;

Putin peace plan is basis of Hollande-Merkel initiative on Ukraine – reports, on Russia Today RT, Feb 6, 2015;

Worse Than Fascism? on ZNet, by Paul Street, Feb 6, 2015;

Interviewing Greek Left Media, Sto Kokkino, on ZNet, by Kostas Arvanitis and Michael Albert, Feb 6, 2015;

NATO involvement in Ukraine is destructive – Russian envoy to alliance, on Russia Today RT, Feb 6, 2015;

UK-US surveillance regime was unlawful for seven years, on The Guardian, Feb 6, 2015: Regulations governing access to intercepted information obtained by NSA breached human rights laws, according to Investigatory Powers Tribunal

Canada: The Harper government and evangelical capitalism, on, by Joyce Nelson, Feb 6, 2015;

Canada’s inconvenient truth about Mexico, on, by ELVIRA TRUGLIA, Feb 5, 2015;

Iraq tightens its belt, on Al-Ahram weekly online, by Salah Nasrawi, Feb 5, 2015: The people of Iraq will face severe hardships under the country’s new austerity budget …;

Yemen’s new rulers, on Al-Ahram weekly online, by Nasser Arrabyee in Sanaa, Feb 5, 2015: Following the resignation of the Yemen’s president and prime minister, Houthi rebels are taking steps to control the entire country …;

The Arab media war, on Al-Ahram weekly online, by Amira Howeidy, Feb 5, 2015: The Saudi-funded Al-Arab TV broadcast for only a few hours before it was suspended by the Bahraini authorities. The episode says much about the region’s media map after the Arab Spring …;

Ukrainian Government: No Russian Troops Are Fighting Against Us. Sanctions against Russia based on Falsehoods, on Global, by Eric Zuesse, Jan 31, 2015;

Glenn Greenwald nails the Charlie Hebdo affair, on Paul Craig, by Glenn Greenwald, Jan 11, 2015;


… and this:

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