More people in the Netherlands end their lives by stopping eating and drinking, according an investigation by Erasmus medical centre researchers and quoted by the Volkskrant.

Some 5,800 people, or 3.5% of all deaths between 2019 and 2023, were due to voluntary starvation, an increase of 1.4 percentage point compared to 20 years ago.

In most of the cases, the people who chose to starve themselves had applied for euthanasia but their request was rejected. Euthanasia accounts for 5.8% – or 10,000 – of all deaths a year.

People who choose to starve to death often do so at home but it also takes place in hospices or nursing homes. Two-thirds would have preferred euthanasia and a third explicitly named the rejection of their request as the reason for stopping to eat and drink, according to close relatives and friends of the deceased.

The researchers examined two of the best-known methods of ending one’s life independently, without the direct help of a doctor. After starvation, a deadly combination of pills is the most frequently used option.

Some 2,000 people, representing 1.2% of all deaths, end their lives like this, a number has not significantly changed in 20 years.

Support from doctors or relatives of people who want to starve themselves to death, such as by administering painkillers or making them more comfortable by wetting their mouths, is not illegal. The method is not seen as suicide and is registered as “death from natural causes”.

“We hear from people that doctors sometimes steer people that way,” Fransien van ter Beek of the Dutch right-to-die association NVVE told the Volkskrant. “It certainly happens in cases where the case is very complex and doctors don’t want to get into trouble over euthanasia,” she said.

Two-thirds of people who starve themselves to death are over 80. Those who opted for pills were mostly aged between 30 and 70, often had mental problems and had tried to commit suicide before.

Completed life

The main reasons for ending their lives ranged from considering their life “completed”,  loss of dignity or a sense of meaninglessness, pain or loss of independence. Part of the group valued being able to decide for themselves as the main driver.

“With the proper preparation and support from friends or relatives and doctors, the conscious decision to stop eating and drinking can lead to a dignified death,” researcher Fenna Bos said. “Don’t do this on your own; speak to your relatives about it if you are planning this,” she told the Volkskrant.

Critics, among whom former NVVE director Petra de Jonge, have called the method “barbaric” and “medieval” for healthy people and only acceptable for the very old and weak.

Right support

The organisation has since accepted that starvation can lead to a dignified death but only with the right support. Van ter Beek said. “Without that, it can be horrendous,” she said.

The fact that people turn to starvation because they are being denied euthanasia is “extremely sad”, she said. “It shouldn’t be necessary. People who have thought about it and want to die would be helped by a doctor or a counselor,” she told the paper.

Research carried out by the NVVE in 2024 showed that over seven in 10 people think the Netherlands should bring in legislation to make it possible to help the frail elderly who feel they have reached the end of their natural lives to die.

Anyone struggling with suicidal thoughts can call or chat anonymously by calling the helpline 113, or 0800-0113 or online at 113.nl.