Relational autonomy and self-chosen death in the Netherlands:A critical analysis of the law proposal ‘Wet toetsing levenseindebegeleiding’

Abstract

In Pia Dijkstra’s law proposal regarding elderly people and assisted suicide in case of ‘a finished life’, autonomy is a central concept. Dijkstra argues that the new law proposal will enhance the autonomy of elderly people with a wish to die without unbearable suffering. The way autonomy is approached portrays a focus on rationality, independence, self-consideration and individual choice. In the past decades relational lines of critique have been developed against the traditional approach of autonomy, introducing a relational understanding of autonomy. These approaches try to incorporate emotions, relationships, embedded selves and the asynchronous nature of autonomy. Dijkstra also implements the notion of relational autonomy in her proposal, adopting the term from the 2016 report by the committee of Independent Experts directed by prof. dr; Paul Schnabel. She also builds on insights found in the 2020 Perspective research directed by van Wijngaarden. I build my arguments mostly on accounts of relational autonomy by Gómez, de Maeseneer and Gastmans., Walter and Friedman Ross, Winzelberg, Hanson, Tulksy and Baumann. I introduce three arguments: firstly, the dependence argument in which I argue that A) being dependent is not a threat for autonomy and B) making an autonomous choice cannot be done completely independently. Secondly, I present the ambiguity argument in which I argue that A) the proposal overestimates rationality and reason and B) overlooks the ambiguity of the decision-making process. Thirdly, I present the contextual argument in which I argue that A) the proposal only incorporates relational autonomy in an accidental way and B) incorporates relational autonomy in an instrumental way. In the end I conclude that, while Dijkstra tries to incorporate relational insights on autonomy, she does not sufficiently do so.