26 October 2012

Why a husband and wife chose euthanasia

Excerpts from a poignant essay at the Washington Post:
I was living in comfortable retirement with my wife, Mathilde, when, at the age of 71, she received a diagnosis of Waldenstrom’s disease... Then, after seven years, the cancer suddenly turned aggressive and the treatment no longer worked...

But we live in the Netherlands, and here is where our story becomes a little different. When people become as ill as my wife, with no prospect of cure and only pain and exhaustion in the offing, it is quite legal to end one’s life by voluntary euthanasia... We made sure all the doctors who joined our village medical practice knew our wishes, and we always asked whether they would administer euthanasia. As an added precaution, Mathilde continued to carry a thick wad of forms and declarations in her handbag wherever she went, in case of an accident...

All the doctors agreed to our request. They were from a younger generation; it is older doctors, mainly, who are reluctant to administer euthanasia. A few refuse on grounds of principle, others because they just do not wish to become involved. But more than 80 percent of all Dutch family doctors, according to a recent large study, report that they have performed euthanasia at least once, and among the willing doctors the average rate is once every two or three years...

Euthanasia is by now widely accepted here. It is supported by the vast majority of the population, of the medical profession and of the political parties. The costs for it are borne by our compulsory health insurance, and suicide clauses voiding life insurance policies have been set aside. Still, it is an onerous task for the attending physician, and it also demands paperwork and careful planning. Demands for euthanasia are not made lightly and are more often denied than granted, largely because of insufficient forethought...

The law lists four major conditions for euthanasia. It must be administered by a doctor; the patient must earnestly desire it, a resolve taken after due deliberation, and freely; there must be no prospect of recovery and, in the words of the law, the patient must be suffering unbearably. The attending physician must confirm that these conditions are met and write a report to this effect...

To the nurse she said, “I am ready” and to me, “I am not afraid.” I sat on one side of the bed and took her hand, and the doctor, at the other side, gave her the first injection. She immediately fell asleep, snoring loudly. The doctor gave her a second injection, and the snoring stopped. She had died. It was all over in a couple of minutes...
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  1. The Dutch have done it correctly ~

  2. I have a grandmother who has Parkinson's disease. My wife, son and I took care of her for nearly two years. She finally needed more medical care than we were qualified to provide and she had to move into a nursing home. She basically does not recognize us anymore. I am her oldest grandchild and have always been very close to my grandparents. My heart aches to see her in a state that seems so useless. My grandfather also died of a muscular disease called polymyositis. While mentally acute, he was physically helpless for the last two years of his life. I understand where the anguish comes from in this situation.
    That being said, God is the giver of life and He is the taker of life. Both of my grandparents agreed with this. Until his last days, my grandpa's famous words were, "God makes no mistakes!"
    I admit that the one condition mentioned above that was not present with my grandparents is the pain. I realize this complicates the matter even more emotionally. I still believe that life is in God's hands.

    1. Different people have different experiences and form different conclusions.

      I took an extended leave of absence from my job to move in with my father in his one-bedroom mobile home on the Texas/Mexico border. He had widely metastatic prostate cancer than had been ineffectively treated with radiation therapy and thus had bowel obstruction from the adhesions. By the time he asked me to help him, he had mets to his bones, causing rib pain whenever he moved or strained at the toilet. I slept on the couch and could hear him each night moaning in the bathroom. I gave him as many pain pills as possible, but the side effect of narcotics is constipation, which in connection with his hypercalcemia aggravated his bowel problems. He lived in misery those last few weeks, helpless and in pain, and if that was God's plan, then I have no use for such a god.

    2. When a loved one suffers so profoundly, it tortures not just them. I also do not have use for a god that dictates that you and all who love you suffer until the pilot light goes out on its own. That makes no sense. We intervene in so many other cases where god would otherwise, seemingly, take his time.

      There are ways to check out without any help or permission from anyone. --A.

  3. My home state of Oregon has an assisted suicide law. Back in 2007, our largest newspaper ran a series on a courageous woman named Lovelle Svart, who had retired from that newspaper and, when she was told that she had six months to live, contacted her old workplace and invited them to accompany her on her journey. She said our society does not talk about death enough, and to make an informed decision on euthanasia, first one should be…informed.

    The result is a series of video diaries by Lovelle, with accompanying text, right up to and including her death by euthanasia. It is an astonishing journey and one that should be required viewing/reading for anyone engaging in a discussion on this topic. It's impossible to get through the end -- which is an audio recording of her final moments -- without tearing up.

    But she died exactly as she wished, surrounded by friends and loved ones, after having danced the polka one last time.

    You can view it here:

  4. Those who have seen loved ones suffer a lingering, painful death would not wish that upon anyone.

    The author made it clear, what was done was done out of love and respect.

    I have no experience with assisted suicide, only euthanasia of beloved pets and horses. At the point when the needle is poised, there is the terrible, awful feeling of wanting to stop time, stop the procedure, wish that the animal I was holding was well and whole again.

    But for the sake of the cat, the horse, I was calm and quiet. I know I would wrestle with the same decision applied to a much loved person. But I also do not believe there is anything noble or edifying in relentless suffering. Relatives have made it clear that they do not want extended measures- feeding tubes, chemo in extreme old age-anything that prolongs meaningless life that is measured in urine output, respiration and pain scale charts.

    The author was calm and brave. Could I do the same if it were my mother or my spouse? It gives me a lot to think about.

  5. Not only do the Dutch have a very humane euthanasia law, end-of-life things have been arranged very well in general in the last decade or so. Doctors start the conversation about end-of-life choices with all elderly people, especially those with progressing diseases such as dementia. The patient can then make decisions and those will be executed.

    I've seen this with two grand-parents. They had dementia and slowly faded into the haze. At some point, the doctor called the children, informed them that a point had been reached where my grand-parents had decided to terminate/refuse treatment and that death would follow soon. Both of them died peacefully surrounded by their children and other close family. It did not work that way in the 80s when my other grand-parents died.

    What I love about the situation is that people get to think about the end of their life when they are still completely capable of making sane and informed choices. Once picked, their choice is executed. This saves the next of kin an enormous amount of emotional stress because nobody is confronted with questions whether treatment should be continued and how.

    It is also great because everybody can make choices based on their own beliefs. Religion often becomes a hot topic in end-of-life discussions, however there are massive differences of opinion between different religions. What does it mean that 'god has given like and can alone take it'? It that a yes or a no to prolonged medical treatment?

    Of course, it helps that the Dutch have mandatory insurance, completed with a form of Medicaid, so that money has no place in health decisions. As long as you pay your premiums (and the government will force you), you're covered without back-breaking co-pays.

    1. "Of course, it helps that the Dutch have mandatory insurance, completed with a form of Medicaid, so that money has no place in health decisions. As long as you pay your premiums (and the government will force you), you're covered without back-breaking co-pays."

      Spot on. There are a lot of people making lots of money from end-of-life care in this country who actively oppose any legislation or technique that would shorten that process.

  6. As an atheist, I find the suffering of friends who have religious beliefs perplexing. My family has never been spiritual, and we tend to really enjoy the time we have together. My wife, who comes from a Catholic upbringing, doesn't really get the attitude that my family has. But even though I'm relatively young, I've let her know in no uncertain terms that when it's time for my life to end, however grueling it will be for her, she should take solace in the fact that I consider it part of living -- a necessary end to a cosmically incredible accident that put the molecules from dead or dying stars together to form me, and instead of mourning me, to cherish the incomprehensible chance that had to occur for us to meet and spend time with one another. To me, it is very comforting that my death will just put more star stuff back into circulation. I'd really like to be able to have the option that the Dutch have.

  7. A friend of mine said it very well: "We treat our pets more humanely than we do our human loved ones."


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