AMSTERDAM (AFP) — They died together, holding hands. Their last words? “I love you.”

Bert Keizer, a 77-year-old Dutch doctor, has helped more than 125 people to die, but this case hit him hard because this time it was a couple, “two superb women.”

Monique, 74, suffered from dementia; Loes, 88, from a muscular disease.

They relied on each other for an independent life and, after 50 years together, could not imagine life without the other.

Keizer described their final moments.

“The two women lay on a bed, holding hands. They both had a drip in their arms and a doctor at their side,” he told AFP.

“They kissed, said ‘thank you’ and ‘I love you.’ We looked at each other and said: ‘Are you ready, girls?’ ‘Yes, let’s go,’ they replied.”

“We injected the medication, a barbiturate, and they fell asleep immediately.”

The doctor said he was nervous because “they have to fall unconscious at exactly the same time, and you don’t want one to see the other die.”

After several years of suffering, Monique and Loes opted in 2019 for a “couple’s euthanasia,” which allows partners to die at the same time.

“One of us has lost her mind, the other her legs, they used to say. Two superb women. So nice,” recalled Keizer, who has retired but still helps people who choose euthanasia.

The Netherlands and Belgium were the first European countries to legalize euthanasia — voluntary death assisted by a doctor.

The procedure is strictly regulated in the Netherlands. A doctor and an independent expert have to judge that a patient is enduring unbearable suffering with no hope of improvement.

It also requires that a decision to die is carefully considered, is of a patient’s own free will, and there is no other “realistic option.”

‘Emotionally difficult’

In the case of a couple choosing euthanasia, these conditions have to be met for both patients and assessed by two different doctors. It is, therefore, extremely rare.

“It’s, of course, unusual that two lives meet all these conditions at exactly the same moment,” said Keizer, who has carried out 140 euthanasia procedures in his career — but only of two couples.

More people are turning to euthanasia in the Netherlands. According to the most recent official statistics, 8,720 people died this way in 2022, 5.1 percent of all deaths.

Most suffered from terminal cancer.

Of these, 29 were couples. While couples euthanasia remains rare, it’s also increasing. In 2021, 16 couples died this way. In 2018, there were nine.

The spotlight was shone on the practice in February when it emerged that former prime minister Dries Van Agt had died by euthanasia along with his wife of 70 years.

“The way the Van Agts died is a great example of dying with dignity while staying in control,” said the pro-euthanasia group NVVE at the time.

Monique and Loes died together after receiving the green light from the medical teams treating them.

“I found it emotionally difficult because they were such adorable people,” but also very determined, recalled Keizer

Monique was perfectly aware of the extent of her dementia, which is also rare. “Most people with dementia do not realize how serious their illness is,” the doctor said.

The two women, both short-haired and bespectacled, took part in a TV documentary before their deaths.

“I can’t live without Monique,” Loes said.

“And I depend on you,” replied Monique. “So let’s go together.”