publications

Physicians may hasten death by medical decisions to end life (MDEL) that have been extensively researched. However, outside the medical domain, some individuals hasten their death by Voluntary Refusal of Food and Fluid while receiving some palliative care (VRFF) or by Independently taking Lethal Medication attended by a Confidant (ILMC). Both dying trajectories are more or less under the control of the individuals themselves. No survey data are available on how often these self-directed deaths occur in the Dutch population. We have isolated VRFF and ILMC from other dying trajectories in a populationbased study employing after-death interviews with relatives, friends or nurses. Members of a research database that is representative of the Dutch population (n 1/4 31,516) were asked whether they had been a confidant in someone’s decision to hasten death by VRFF or ILMC. In this sample, 144 deaths that conformed to our definitions were reported by proxies. We have computed an annual frequency of 2.1% VRFF deaths and of 1.1% ILMC deaths. The annual frequencies of VRFF and ILMC appear to be roughly the same as the yearly frequency of physician-assisted dying (1.8%). In seventy percent of those who had died by VRFF or ILMC, a diagnosis of cancer or a serious illness was reported by the informant. The proxies retrospectively described the self-directed hastening of death by both methods as a dignified death in about 75% of deaths. Both VRFF and ILMC require strenuous efforts and reflect a strong desire to control the process of dying. End-of-life research has shown that some control over the time of death is an important aspect of a ‘good death’ in western countries. We therefore presume that these self-directed methods for hastening death in consultation with proxies occur in other countries as well.

The literature provides conflicting opinions as to whether it might be a good or a horrible death. Dr. Chabot has tried to disentangle the knot of conflicting information by analysing 110 cases that were reported to him by relatives, nurses and doctors. He outlines what circumstances have contributed to a good death and why other cases resulted into a bad death.

A humane and self-chosen death should preferably take place wtih emotional support and comfort from others. Suggestions are given for relatives and friends who may wish to be present with a dying loved one without legal harm to themselvies.
The methods in this book require careful planning in order to achieve a pieceful death. An individuele can carry out the steps without substantial involvement from others.

In the seventies psychoanalytic psychotherapy with client-centerd and behaviour therapy in it trail had become fashionable. However, empirical evidence for its efficacy was scanty. Chabot voiced an ardent plea for de-professionalization of therapeutic interactions between laypersons. Only 20 years later this was acknowledged as a serious alternative for professional psychotherapy.

The frequency of physician-assisted death has doubled over the last five years (2010-2014). A revision of the euthanasia law to bring the option of a Drion-pill for the elderly within this law has been discussed in Parliament but failed to find a majority. Chabot analyzes the implications of the increasing acceptance of non-doctor assisted dying for the relationship between family and nursinghome doctors and their patients.

Toghether with Chabot, journalist Stella Braam has rewritten the results of Chabot’s research (2001 Dying is Hard Work and 2007 Self- Euthanasia: Hidden Dying Trajectories attended by relatives) that is accessable for laypeople (Published by Singel Publishers). In 2015 the 10th updated edition appeared. This testifies to the need of elderly and very ill persons for practical and detailed information.

The relationship of paternal authority doctors assume to have in their relationship with very ill or dying persons gives them a huge lead in any decision a patient wants to take how to die. Chabot argues that the balance of power could be restored by giving the patient information, or at least referring him to published infomation on a self-chosen and humane death.

This first how-to-do-it guide for a self-chosen death with medication or helium that was published by the Dutch Society for Scientific Research (WOZZ Foundation). The authors were Dutch anesthesiologist Pieter Admiraal, Boudewijn Chabot and Canadian criminologist Russel Ogden. Technical advice by Jsn Glerum, professor in pharmacy and Aad Rietveld, a toxicologist.

Chabot constructed an online research questionnaire for a self-chosen death in consultation with the intimiate circle of family and friends, by either medication or voluntary stopping eating and drinking. With this questionnaire a survey was done in a randomly drawn sample (n= 21.500) from the population. For this academic study Chabot received a PhD with honours. The results were published in Social Science & Medicine

In 1991 Huib Drion, a law professor, argued that elderly persons over age 75 should get access to a lethal pill if they considered their life to be completed. Chabot discusses the developments in Dutch society that will make the availablility of such a ‘pill’, erroneously called the ‘Drion Pill’, ever more prominent in the public debate. He sketches the outlines of two scenario’s that will come about in the near future: a doctor-assisted and a non-doctor assisted road. Which one will become dominant?

This book is a preliminary study for Chabot’s PhD thesis in 2007. It discusses the insights gained from twenty in-depth interviews with relatives of persons who died by the medication methdo and with right-to-die counselors of the Dutch NVVE and The Horizon. Erving Goffman’s famous book “The presentation of Self in Everyday Life’ provides the theoretical framework for an analysis that takes into account four different perspectives: (1) the patient and his intimates, (2) the suicide counselor, (3) the family doctor and (4) the authorities.

Dutch psychiatrists are often confronted with persistent requests for physician-assisted dying. Drawing on his own long experience with this request, especially from patients with a personality disorder, Chabot provides specific steps how to change the focus from doctor-assistance to the responsibility of the person himself for a self-directed humane death.

This book is a collection of twelve essays in which the author answers the criticisms that had been published after what has became known as the notorious ‘Chabot case’. He explores non-doctor assisted suicide as an alternative for involvement of the medical profession with a self-chosen and dignified death.

This small book gives a detailed account of the case of Netty Boomsma based on her letters, her diary and Chabot’s conversations with her. She was in a state of grief but physically healthy and refused to mourn the dramatic loss of her two sons. After consulting 4 psychiatrists Chabot gave her a lethal dose of barbiturates and reported her death to the police. The Dutch Supreme Court’s verdict – ‘guilty without punishment’ – raised widespread concern among Dutch secular intellectuals and Christian groups.

By close reading the publications of Sigmund Freud, Chabot articulates and criticizes the implicit values of paychoanalysis. Religious beliefs are not‘childish’as Freud had put it. Psychoanalysis, Chabot argues, cherishes an ideal of ‘psychological man’ as the summit of moral adulthood.

In the seventies psychoanalytic psychotherapy with client-centerd and behaviour therapy in it trail had become fashionable. However, empirical evidence for its efficacy was scanty. Chabot voiced an ardent plea for de-professionalization of therapeutic interactions between laypersons. Only 20 years later this was acknowledged as a serious alternative for professional psychotherapy.

Illegal abortion surfaced as an urgent issue in Dutch society in the nineteensixties. Chabot explored pro and con and 1968 took a position that at the time was progressive: in the first 12 weeks of pregnancy the woman herself should have the right to decide whether or not to continue the pregnancy.

Flyer_4.Auflage

2015 Sterbefasten 4 Auflage Vorwort

2008 Wege zum humanen, selbestimmten Sterben