Nic and Trees Elderhorst chose euthanasia together after 65 years of marriage. (Photo courtesy: The Mirror)

There are love stories that end with a goodbye. And then there are those in which even the final goodbye is shared. For Nic and Trees Elderhorst, both 91, the fear of being separated in their final years was greater than the fear of death itself. After 65 years of marriage, the Dutch couple chose to die together through euthanasia- a rare decision that attracted international attention in 2017.The couple, who lived in Didam in the Netherlands, had spent more than six decades together. But their final years were increasingly shaped by health problems. Nic had suffered a stroke in 2012 that severely affected his mobility and left him in constant pain. Trees’ health had also deteriorated, while her memory was declining. She was later diagnosed with vascular dementia.Their health problems also changed the way they cared for each other. Although family members, friends and neighbours helped them, the couple feared what would happen if one of them died before the other.For Trees, there was a particular fear of being left alone and eventually having to move into a nursing home.

‘Dying together was their deepest wish’

According to The Independent, the couple’s daughter said a geriatrician had determined that Trees was still mentally competent when the family began considering the couple’s request.The daughter said her mother feared that if her husband died first, she could become completely disoriented and end up in a nursing home- something she desperately wanted to avoid. “Dying together was their deepest wish,” she said, according to the report. The decision, however, was not made overnight.

Six months of medical assessment

Euthanasia is legal in the Netherlands, but only under strict conditions. A doctor must establish, among other requirements, that a patient is experiencing unbearable and hopeless suffering and that the request is voluntary and well considered.The Elderhorsts therefore had to undergo an extensive assessment before their request was approved. They spent six months with an End of Life clinic, where they were assessed separately by two teams of healthcare professionals. Doctors, psychologists and psychotherapists were involved in determining whether both individuals independently wanted euthanasia and met the legal requirements.That separate assessment was important because the law does not allow euthanasia simply because two people want to die together. Each person has to qualify independently.

The 91-year-old couple chose to make their final journey together. (File Photo)

Their final moments were together

On June 4, 2017, the couple died at their home in Didam, surrounded by family and friends. Nic and Trees gave each other a final kiss before dying together.Their story was unusual precisely because simultaneous euthanasia for couples is extremely rare. Both partners must happen to meet the demanding medical and legal conditions at roughly the same time.Dick Bosscher of the Dutch Association of Voluntarily Life Ending told The Independent that such cases require a coincidence in which both people meet the requirements for euthanasia simultaneously. Dual requests, he said, are therefore rarely granted.

A difficult conversation about the right to die

The Elderhorsts’ case also brought renewed attention to the debate surrounding euthanasia and end-of-life choices. The Netherlands was the first country to legalise euthanasia under a regulated legal framework, but the system remains subject to strict safeguards. Age or simply being tired of life is not, by itself, enough to qualify.For this couple, however, their final decision was closely tied to their health, their fears about the future and, above all, their desire not to face the end of their lives apart.After 65 years of marriage, they had spent most of their lives side by side. In the end, they chose to make their final journey together too.