Last Selfie Before Euthanasia

I was recently leafing through one of the Dutch daily newspapers.. On the third page, almost half a column long, there was an article—a report from a clinic that performs euthanasia and an interview with one of the doctors performing it.

Next to the article’s content was a rather large photo of a patient about to undergo euthanasia. The patient was sitting in bed, surrounded by family members. Everyone was looking directly at the camera, their faces were rather expressionless. The article indicated that the patient had been suffering from depression for many years, which she had recently “been unable to cope with.” After many discussions with her family and doctors, everyone agreed that euthanasia was the best solution to this “life of suffering.” The procedure was scheduled for a specific day and time and performed in accordance with the wishes of the patient and her family.

The doctor, head of the clinic, discussed the Dutch national law on euthanasia, which can be requested by patients who meet two basic criteria: they experience “continuous and unbearable” suffering (mental or physical) and their condition is “incurable.”

Since 2002, the Netherlands has had a law specifying the principles and conditions of euthanasia—the “Termination of Life on Request and Assisted Suicide Act”— which is amended almost annually. The concept of “suffering qualifying for this procedure” is gradually expanding, and the number of people undergoing euthanasia is increasing year by year. For certain conditions, family members can also apply for euthanasia on the patient’s behalf. In recent years, approximately 8,000 -10,000 people have undergone euthanasia annually, accounting for approximately 5-6% of all deaths in the Netherlands (it was 10.341 people in 2025). The vast majority of patients had cancer (about 50%), but also heart disease or nervous system disorders such as Parkinson’s disease and multiple sclerosis. However, approximately 5% of this number had dementia, where euthanasia was approved at the request of the family, and the number of such cases is increasing year by year (by about 10% per year).

Similar laws are in force in Belgium and Luxembourg. In Belgium, a 16-member euthanasia commission — half are doctors and half are lawyers — meets monthly in Brussels. By law, after performing euthanasia, doctors must submit a report to the Commission detailing what they did and why. The Commission reviews the reports to ensure that the conditions set by law have been met.

I am reaching for a book by Alfred Hoche and Karl Binding, originally published in  1920 in German, but translated into English and republished in 2012: “Die  Freigabe  der Vernichtung lebensunwerten Lebens: Ihr Mass and ihre Form”, which can be  translated as  “The scope and form of legalization of ending a life that is no longer  worthy of  continuing.”

Alfred Hoche was a psychiatrist, Karl Binding a lawyer (“half are doctors, half are lawyers”…). When they wrote their book in 1920, they didn’t imagine that they would become the most prominent architects of the German “euthanasia” movement, which was ultimately implemented in Nazi Germany, in the so-called T-4 program. Hoche and Binding begin their analysis very subtly, initially building their proposal on the basis of “human compassion” — first for suicide, then for assisted suicide. They continue to justify the need for social acceptance of euthanasia with the patient’s consent, and finally also for the euthanasia of individuals who refuse to consent and who burden society. They argue that “ending a life deemed devoid of value” —namely, the lives of the terminally ill, but also the lives of the mentally ill (“incurable idiots”) — is justified by the suffering these individuals endure and the economic and social burden that “keeps all kinds of weaklings alive.” In the case of the mentally ill, they write, one must also consider the “suffering of the family,” who witness “the agony of a life devoid of value in a family member.”

The doctor and lawyer argue that in the past, euthanasia “was unacceptable because of the Christian way of thinking,” which “places too much importance on the mere continuation of existence and demands too great a sacrifice from society in caring for the weak and defenseless.” Binding and Hoche propose an alternative solution, “We, doctors, know that in the interest of the entire human organism, it is necessary to discard less valuable members in order to save the entire organism” – this is how the problem of euthanasia should be approached at the societal level. In their book, they described in detail the mechanisms of qualification for euthanasia and the legal and medical aspects of establishing a committee of experts who would decide on the procedure.

Hoche himself was not a Nazi. When Hitler came to power in 1933, he retired from his professorship. He then quickly published two books. The first, in 1934, was published under the title “Jahresringe.” It was part autobiography and part a collection of the author’s thoughts and worldview principles. This book became so popular that it was reprinted in 1935. In August 1935, Hoche published his second book, “Aus der Werkstatt.” Both books were full of philosophical reflections and drawing on classical German conception of identity. Hoche quoted extensively from many literary works, classical poetry, and the views of philosophers.

It is believed that the work of Hoche and Binding formed the basis for the euthanasia program in Germany after 1933. It is estimated that this “enlightened ethics of euthanasia” led to the killing of approximately 400,000 mentally handicapped people, invalids, as well as thousands of children for reasons sometimes as trivial as “bedwetting,” and tens of thousands of elderly Germans who were classified as “useless people.”

We are now accustomed to assurances that Nazi and communist totalitarianism were such an “episode” in human history that they can never be repeated. Let’s ask ourselves – is that really the case? Communist crimes, including euthanasia, have been largely forgotten for decades and are not particularly publicized, for example, the communist crime of the famine in Ukraine (Holodomor), which led to the deaths of approximately 10 million people, is no longer frequently brought to mind.

Hoche and Binding published their book in 1920, but their concepts have not disappeared in the era of modernity and postmodernity.

Joseph Fletcher, a professor of ethics (who died in 1991), argued similarly for the practice of euthanasia in his book “Morals and Medicine” back in the 1950s and 1960s. In 1966, he published his work “Situation Ethics”, which became something of a modern-day book by Binding and Hoche. Fletcher also became a leader in promoting broad abortion rights—so broad that it would effectively be infanticide. He was also active in the Planned Parenthood Federation and co-founded the Association for the Study of Abortion and the Society for the Right to Die.

In 1977, Anthony Shaw, a pediatric surgeon, developed a mathematical “formula” model for objectively calculating and legally legitimizing decisions to withhold medical treatment from infants. This “mathematical model” justified infant euthanasia for very mundane medical reasons and was widely discussed and promoted in professional journals devoted to “bioethics.”

Finally, we have the work of Peter Singer, an Australian philosopher who, while promoting euthanasia (but also abortion and infanticide), is also a proponent of the “animal liberation movement.” Hoche and Binding’s work is merely innocuous reading compared to Singer’s.

The problem of euthanasia (but also abortion) cannot be discussed and viewed in isolation from the changes that our Western civilization is undergoing today. Media propaganda, widespread education, and total brainwashing are aimed at negating the freedom and dignity of the human person. It begins with small matters, with dividing society over trivial matters, with restricting freedom on a local scale – but these experiments will serve to implement changes on a mass scale and in fundamental matters.

As Chantal Delsol argues in her writings, particularly “Les Pierres d’angle : À quoi tenons-nous?”, the individual comes to be regarded solely a “societal resource”.  Society is supposed to make decisions for the individual – the individual is no longer regarded as a person, but merely a part of a larger Whole that thinks and decides on their behalf. This practice of making decision on behalf of the individual is often presented as an expression of care, concern, and respect. Yet it is obvious that this is not always motivated by genuine respect for the individual — quite the opposite. In the herd, the individual is no one special: they lose their dignity and are expected to submit to the dictates of the majority.

In the case of euthanasia, the fundamental criterion for determining the value of a human life is the assessment of whether “the person suffers” and “social empathy for a living being”. By accepting this criterion, we forget — and indeed reject — the fact that in our culture, we have traditionally given human life a much greater significance than reducing it to so-called “suffering.” Christian ethics undoubtedly played a crucial role here, but even for those who do not consider themselves Christians, our centuries-old European identity and tradition, which regard the human person and their fate as unique and unrepeatable, and not subject to imposed collective decisions, have been essential to preserving human dignity.

Today, in the postmodern era, all propaganda and educational efforts are directed at eradicating the notion of the uniqueness of the human person. First, the concept of transcendence is eliminated, faith is separated from reason, facts from values, and the human person is reduced to the status of an animal in a herd. Humans cease to be persons, though they may remain “individuals,” as Maritain writes—but these individual are stripped of their identity and their freedom, understood also as free will. Such animals must then be convinced to accept their position. They should, of course, be treated well, as all animals should be, but they are deprived of their freedom in matters of ultimate importance.

Delsol writes that Christianity stripped holistic society of its power over human life and entrusted it to God. This uniqueness of the human person, grounded in their relationship with God, simultaneously endowed them with dignity and freedom of choice. When God “withdraws,” the individual takes control of their own life—they become God. Anthropotheism—the belief in the infinite power of man—emerges. Transcendence dies, everything becomes immanent, and human beings become gods on Earth.

But the holism of society and the power of the Whole then quickly reassert themselves – this personal control over one’s own life becomes an illusion and quickly transforms into society’s control over our lives. This Whole then begins to claim the right to decide what kind of life is “worth living”. This concept and assessment of “a life worth living” eliminates the holistic conception of “Personal Dignity.” Eliminating this fundamental concept of Dignity reduces our existence to a mere corporeal existence. We are the same as animals – hence, there is no difference between the death of a human and an animal. Today, people talk about “euthanizing” dogs, claiming that “the dog died” rather than “perished”. Cemeteries for dogs and cats are becoming increasingly popular.

If we allow an ideological majority to confer dignity upon us, we will completely lose our humanity. Stripping our existence of transcendence was a tragic development, even though it ostensibly gave us the power to determine our own fate. At first, such a situation seems magnificent—we become gods unto ourselves. Yet, the experience of recent totalitarian regimes teaches us that this apparent individual freedom very quickly transforms into a necessity of submitting to the will of the majority. And it is the majority that will either grant us dignity or strip us of it.

Delsol notes that dignity cannot be imposed or granted from the outside, regardless of whether it comes from an individual or from society, because: “Dignity knows no criterion and does not require a decision. It cannot be defined by criteria. It is indescribable, indefinable, unnameable, unanalysable, unchangeable, unspeakable, indefinable, irreducible to anything, inexpressible, unclassifiable, incomprehensible and indelible, therefore unconditional.”

Saving our dignity is the task that lies before us if we want to save our civilization.

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