Former Dutch prime minister Dries van Agt died at the age of 93 “hand in hand with his wife Eugenie… at a moment they chose”, his representative said on Friday, inferring the couple, who were both in ill health, had opted for euthanasia.

The news led to a few raised eyebrows, given that Van Agt was a Catholic and politician on behalf of the CDA. But he “always took his own decisions,” said Gerard Jonkman, director of The Rights Forum, the pro Palestine pressure group which Van Agt established.

Van Agt’s health was deteriorating and in 2019, after a stroke, he said that “euthanasia was an option if living and suffering became unbearable”, Jonkman told broadcaster NOS. The health of his wife of 70 years was also worsening, Jonkman said.

Fransien van ter Beek, chairwoman of the right to die campaign group NVVE, told NOS there are some instances of couples dying together, but that it is “not an easy way” to go.

In 2022, 29 couples died together, out of almost 9,000 cases of euthanasia. In 2021, 16 couples did so, and in 2020 just 13.

To qualify for euthanasia in the Netherlands, the patient must be experiencing unbearable suffering with no prospect of improvement. Two doctors must also be involved, and meet detailed criteria covering duty of care.

Doctors treat euthanasia requests from couples as two separate applications, both of which have to go through the same process. Both partners are interviewed separately, so the experts assessing the request can be sure the decision is voluntary.

Two doctors are often involved in carrying out the actual request, so that the couple do both die at the same time. “We know from experience that people are happy with the idea, after a long life in which they have grown together,” Van ter Beek said.

Van Agt and his wife were very ill but could not be without each other, Jonkman said. The couple were buried together on Thursday.