Nic and Trees Elderhorstknew exactly how they wanted to die.

They were both 91 years old and in declining health. Nic Elderhorst suffered a stroke in 2012 and more recently, his wife,Trees Elderhorst, wasdiagnosed with dementia, according to the Dutch newspaper,De Gelderlander.

Neither wanted to live without the other, or leave this world alone.

So the two, wholived in Didam, a town in the eastern part of the Netherlands, and had been together 65 years, shared a last word, and a kiss, then died last month hand-in-hand in a double euthanasia allowed underDutch law, according to De Gelderlander.

Dying together was their deepest wish, their daughters told the newspaper,according to an English translation.

[A terminally ill woman had one rule at her end-of-life party: No crying]

The Netherlands became the first country to legalize euthanasia in 2002, allowing physiciansto assist ailing patients in ending their lives without facing criminal prosecution.

Euthanasia, in which a physician terminates a patient'slife at his or herrequest, is legal in a few countries, including Belgium, Colombiaand Luxembourg. Physician-assisted suicide, in which a doctor prescribes lethal drugs that a patient may take to end his or her life, is permitted in a fewothers, including in certain states in the United States, according toProCon.org, a nonprofit organization that researches countries' legislation on the issue.

We are pleased that we have in the Netherlands this humane and carefully executed legislation that allows the honorable wishes of these two people whose fate was painful and hopeless,Dick Bosscher, ofthe Dutch Association for a Voluntary End ofLife (NVVE), said in a statement to The Washington Post. He said theElderhorsts belonged toNVVE, a165,000-member organization foreuthanasia and assisted suicide in the Netherlands.

,,Ze gaven elkaar een dikke kus en rustig en zelfverzekerd zijn ze hand in hand ingeslapen.Via DG Liemers

Posted by De Gelderlander onThursday, August 10, 2017

In recent years, apparent double-suicides and murder-suicides have been capturing worldwide attention amid an emotional right-to-die debate couples from Florida toParisreportedlyending their lives together.

Assisted suicide has summoned up deep religious and ethical concerns among critics.

In the United States, the subject was widely debated in 2014, when a 29-year-oldwoman who had a fatal brain tumormoved from California to Oregon, where she could legally seek medical aid to end her life. Californiahas since enacted itsEnd of Life Option Act, joining a small number of states where it is legal.

Even in the Netherlands, according to Bosscher withNVVE, theElderhorsts' case is rarein that both of them were able to meet the criteria foreuthanasia under the DutchTermination of Life on Request and Assisted Suicide (Review Procedures) Act. Euthanasiaand physician-assisted suicide can be carried out only when the patient's request is voluntary and well thought-out, the patient is in lasting and unbearable suffering and there are no other solutions, among other things.

Researchpublished this monthin the New England Journal of Medicine revealed that euthanasia and physician-assistedsuicidesaccounted for 4.5 percent of deaths in the Netherlands in 2015, up from1.7 percent in 1990, before it was legal. The 25-year review found that most patients who received assistance had serious illnesses.

It looks like patients are now more willing to ask for euthanasia and physicians are more willing to grant it, lead author Agnes Van der Heide, of Erasmus University Medical Center in Rotterdam, told the Associated Press.

However, Bosscher said that there are more than 15,000 requests foreuthanasia each year in the Netherlands and that only about 6,000 of them are granted.

The Elderhorsts discussed their options and submitted requests for euthanasia a year-long process their daughters called an intense time, according to De Gelderlander.

The couple, who had even planned their own funerals,died July 4.

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How Brittany Maynard may change the right-to-die debate

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Elderly couple got 'deepest wish' to die together in rare euthanasia case - Washington Post