On June 4, media outlets around the world repeated the false story that a 17-year-old Dutch teen had been legally euthanized. The headlines and stories were as sensational as the narrative allowed, usually along the lines of “Raped Dutch Girl Legally Euthanized for Depression.” As it turns out, they also stretched the truth past the breaking point. But that didn’t stop the story from spreading like herpes; nor did it stop the Catholic hierarchy from exploiting it to promote their anti-choice position—all the way up to the Pope. How things played out could serve as a lesson in misinformation, outrage and polarization.
The true story runs something like this: Noa Pothoven struggled with mental illness including anorexia, depression, and PTSD symptoms following sexual violation at ages 11 and 14. Mental health treatment offered little relief. She wrote a memoir about her struggles. At age 16, she sought legal euthanasia and was turned away by a clinic that encouraged further treatment for depression and reevaluation at age 21. In public posts she expressed anguish about this, saying she couldn’t wait that long. She decided to stop eating and drinking. Her family issued the following statement:
“We, parents of Noa Pothoven, are deeply saddened by the death of our daughter. Noa had chosen not to eat and drink anymore. We would like to emphasize that this was the cause of her death. She died in our presence last Sunday. We kindly ask everyone to respect our privacy so we as a family can mourn.”
The true story is terribly sad, and many people reading it have questions about other possible paths. That said, it is unlikely to have spread around the world or produced the backlash against choice in dying that is so sought by the Catholic Church in countries like Italy and the U.S. That is because voluntary refusal of food and water is not euthanasia, and it is broadly legal in places where euthanasia is not. Making it illegal requires giving a government the right to forcibly feed and hydrate a legal adult against their will.
My own sister, like Noa, has struggled with chronic depression and anorexia since childhood. Over the years, she has made more than a dozen suicide attempts or gestures involving pills, a near drowning, setting her car on fire, and jumping from a freeway bridge. The state of Arizona has spent several million dollars keeping her alive or putting her body back together. But they have not force-fed her by tube since she reached adulthood, except when she was unconscious.
VSED vs Euthanasia
Declining to force-feed a conscious adult who does not want food or water is not euthanasia. Some might say it represents the bare minimum of bodily autonomy. Food and water refusal is the way that many animals ease their suffering at the end of life. Voluntary stopping of eating and drinking, VSED as it is called, is recognized broadly (though not universally) as a basic human right. In places where aid in dying is unavailable, it is a choice exercised by some people who are approaching death of old age or terminal illness. The United State Supreme Court has affirmed that competent adults have the right to refuse medical treatments including food and hydration. The medical profession normally respects patient preferences in this regard.
By contrast, euthanasia means actively taking steps to accelerate the end of a life, with the goal being not murder but mercy. It can mean shooting a horse with a broken leg, putting down an aging dog whose movements have become painful, or—for a person who prefers death to their current and anticipated quality of life—prescribing or offering medications that cause the body to shut down.
Legal euthanasia, even under the most flexible conditions, involves layers of diagnosis, repeated assessments of mental status, and reviews by multiple experts. The goal is to determine that the person seeking euthanasia is either terminally ill or experiencing suffering that cannot be alleviated in some other way, and that their desire to manage their own death is clear, voluntary, and persistent. The 2019 movie Paddleton depicts an awkward but tender friendship between two solitary bachelors in which one friend faces his conflicted feelings as the other goes through this process.
Noa Pothoven did not qualify.
Red Flags for Questionable Stories
Serious discussions about death with dignity (and, in fact, about most social policies) involve complexities, mixed feelings, moral gray zones, and in the end, uncertainties about whether individuals made the best possible decisions under difficult circumstances and whether our laws err by leaning too far in one direction or another. We find ourselves up against hard choices that pit our love of life against our respect for individual autonomy. We try to wiggle out by looking for some undiscovered path because we wish that people who want to die could simply be well and whole again. In other words, real discussions about choice in dying are hard and complicated.
That is what made the euthanasia story that leapt from website to website an obvious ringer for sensationalism and propaganda—at least to some watchful eyes. In the words of Naomi O’Leary on Twitter, “It took me about 10 mins to check with the reporter who wrote the original Dutch story. Noa Pothoven asked for euthanasia and was refused.” When O’Leary reached out to media outlets that had published the euthanasia story and provided them with credible facts, they began backpedaling.
In the words of Lauren Chadwick at Boingboing on June 5, the day after the story broke:
“The “edit fuckscramble” is afoot right now at various outlets. This is when manifestly false stories are panic-edited one word or sentence at a time and republished, each version doomed to further revision until something defensible finally results—at least if you forget what the story was supposed to be about in the first place.
I have surely done this myself. All our glasshouses are shattered now, so let’s be frank.”
Like Chadwick, I have written things I found to be untrue and then have scrambled to pull them back, and it feels awful. You might think that a few events of this sort would sober up the whole journalism profession. But this kind of fiasco is likely to keep happening. News and opinion writers are under tremendous pressure to find stories and angles that will go viral, which means looking for outrageous events, hastily narrating them in the most sensational way possible, titling the articles with the most sensational words from the sensational stories—and being the first to print. The kind of stories that are most likely to go viral are those that elicit strong emotions. In our current political context, that means those that are polarizing. They act, essentially, as one half of an argument. Reading and sharing them creates a sense of righteous superiority and outrage against the immoral idiots on the other side. The more outrageous a story is, the more likely to be shared.
The sloppy work of journalists caught in this hurricane becomes fodder for ideologues who further spin stories for their own ends. In this case, propagandists in the Christian Right went hog wild. Religious institutions have long staked out the beginnings and endings of life as their turf, and many conservative believers feel as deeply threatened by choice at the end of life as choice at the beginning. They insist that we should leave these decisions to God (aka his self-appointed human representatives). Many can’t imagine that cherishing life might mean valuing quality over quantity. Consequently, the seemingly outrageous euthanasia story proliferated across Catholic and Protestant “right to life” sites, among the same people who vocally oppose abortion and, sometimes, contraception—and child protection and social services and healthcare for all, but I digress.
For those of us who don’t like being played and do like knowing what’s real, but who at least briefly believed the initial report, the Noa Pothoven story is a learning opportunity. Getting burned and disliking the experience can train our gut to be selectively skeptical about stories that are false or distorted. Here are some giveaways: if it seems too outrageous to be true, it likely is. The stronger your urge to share a story, the more likely that the writer has omitted important nuance, contradictions, or details that would complicate your emotional reaction. The more cleanly a story fits the worldview of your homogenous political or religious community, the more likely someone has polished it for that purpose. The more righteous or superior an internet story makes you feel, the more likely you have caricatured the people involved. The stronger your sense that the experts involved were idiots, the more likely your certainty exceeds your knowledge.
When we feel inclined to use the words “incredible” and “unbelievable,” it may be wise to pause and remember what they mean.
Valerie Tarico is a psychologist and writer in Seattle, Washington. She is the author of Trusting Doubt: A Former Evangelical Looks at Old Beliefs in a New Light and Deas and Other Imaginings, and the founder of www.WisdomCommons.org. Her articles about religion, reproductive health, and the role of women in society have been featured at sites including The Huffington Post, Salon, The Independent, Free Inquiry, The Humanist, AlterNet, Raw Story, Grist, Jezebel, and the Institute for Ethics and Emerging Technologies. Subscribe at ValerieTarico.com.
Valerie – This is one of your best posts of the year. Hard-hitting and spot on. I like the way your controlled anger shows itself with finesse.
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Thank you, John.
I read many articles including the one that said it was false and explained the waiting list for mental health care. My thing is, this young lady didn’t have to die. With proper mental health care, she could have overcame her eating disorder, but instead, when she was hospitalized, they only treated her symptoms and not the issues causing her anorexia, which is often comorbid with PTSD and depression, especially if it’s triggered by a traumatic event such as rape. They could have done more than just kept her alive during the one hospitalization and yes, maybe she might have needed a second go at hospitalization, but from what it sounds like, her whole case was completely mishandled. She could have recovered… eventually. She didn’t have to die.
Well, it seems like the Dutch euthanasia board agreed with you–at least that recovery was within the realm of possibility–given that they denied her request.
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I think you’re right. IMHO, this was suicide and her parents let her do it (let her isn’t quite right). At 17, it’s difficult to force your child to eat or accept medical treatment is if they don’t want it. You can’t set them down and say, “You will do this, because I love you and you need this to survive.” They won’t listen and they won’t do it. In her case, if they fought her and put a tube in her, she’d just pull it out or worse, use what little reserves she physically had to fight them over it and die sooner (stress on her heart). It was a damned if they did and damned if they didn’t situation. At the same time, media jumped on the fact that the hospital sent her home with a hospital bed and spun it to make it come out as euthanasia, which it was not. I also think this story is up there with Karen Carpenter’s story, but back then we just beginning to learn about eating disorders. Since then, there’s been improvements for those with anorexia, including those with a comorbid Dx, IF they get the mental health care needed. It doesn’t have to be a death sentence. It doesn’t mean one won’t struggle with it for a lifetime, but it doesn’t have to be a death sentence or a life of misery either.
There’s a decent, concerned, intelligent approach like yours; and then there are clicks.
I don’t know that embarrassment actually exists anymore; Not if the story went viral. ‘Egg on my face? Maybe, but it was PAYING egg.’
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I really enjoyed reading this article sad as it is. Personally I’m all for voluntary euthanasia for those who have reached to end of live through illness, pain and suffering which cannot be fully relieved but only at the request of the person concerned. I also think it’s important to make our doctors aware of our wishes.
In the state of Victoria, Australia Voluntary euthanasia is being introduced this month to those with terminal illness with less than 6 months to live, we are hoping other Australian states will follow through. Thanks for this article Valerie.
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She didn’t have a terminal illness though nor did she have euthanasia. She did have a mental illness that can be treated if one receives proper mental health care and not just have the symptoms treated. There were so many things wrong with this case, including false reporting on her death.
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Another sad example of how “righteous” people are so convinced of their narrow-minded dogma that they are willing to throw truth under the bus in order to advance their beliefs. Like the abortion issue, too many people think in absolutes, black and white, right or wrong. Life is more complex than that, like poor Noa’s situation, and that’s why we have to think carefully about each situation instead of turning to our rule book for pat answers. (Also, speaking as a doctor, mental health is treatable but it is not always possible to achieve cure or remission, and in many cases it is a terminal illness. I hope some day that will change.)