title: Till Death Do Us Part: The Lived Experience of an Elderly Couple Who Chose to End Their Lives by Spousal Self-euthanasia.
abstract: This article provides the first qualitative account of spousal self-euthanasia in older people, a previously unexplored phenomenon. It investigates the lived experience of a Dutch elderly couple who strongly wished-and chose-to die together at a self-directed moment, despite not suffering from a life-threatening disease or severe depression. It describes their subjective experiences and considerations prior to their self-chosen death.
  
  
  
  The case study focuses on the particular experience of one elderly couple (aged above 70) by presenting two personal accounts from an insider perspective. These were analyzed using a thematic existential phenomenological method.
  
  
  
  Spousal self-euthanasia-which in the literature is associated with self-deliverance, self-determination, and a reasonable wish to die-is presented here as related to alienation from one's body and identity, the growing emptiness of life due to loss of activities, and an inability to reconcile oneself with one's changed "being-in-the-world." Their decision to end life is largely based on the anticipatory fear of further deterioration, further losing control, and not being able to control time and manner of death in the future. The couple's agreement to end their lives together, however, held both in an impasse, as their concerns, sense of time and logic differed significantly. In this case, a close relation between having a death wish and severe depression is questioned.
  
  
  
  This article concludes by outlining the practical implications for professionals working in gerontology and recommends further research on the relation between self-euthanasia and depression in elderly people.
authors.affiliation: Department of Care and Well-being, University of Humanistic Studies, Utrecht, The Netherlands. els.vanwijngaarden@phd.uvh.nl.
authors.forename: Els J
authors.initials: EJ
authors.lastname: van Wijngaarden
authors.affiliation: Department of Care and Well-being, University of Humanistic Studies, Utrecht, The Netherlands.
authors.forename: Carlo J W
authors.initials: CJ
authors.lastname: Leget
authors.affiliation: Department of Care and Well-being, University of Humanistic Studies, Utrecht, The Netherlands.
authors.forename: Anne
authors.initials: A
authors.lastname: Goossensen
mesh_terms: D000368:Aged; D001293:Attitude to Death; D003863:Depression; D033101:Euthanasia, Active, Voluntary; D005260:Female; D006801:Humans; D008297:Male; D009426:Netherlands; D026684:Personal Autonomy; D036301:Qualitative Research; D018454:Spouses; D013405:Suicide
keywords: Death wish; End-of-life; Qualitative phenomenological study; Suicide pact; The Netherlands