This is going to be a tough post for me, but I feel it is an important topic. One of the themes that has been prominently on my mind lately is euthanasia. In the Netherlands, where I live, the laws and regulations for euthanasia have been shifting lately, which has caused a lot of discussion about the term “voltooid leven” or “a completed life”. The basic question is: what are the requirements for someone to decide to end their life, and how can we legally support this?
There’s a difference between assisted dying and euthanasia. In the case of assisted dying, a physician provides the medication needed to terminate the patient’s life, after which the patient administers this medicine themselves, in their own time. With euthanasia the medicine is administered by a physician, usually by giving a lethal injection.
The only countries where euthanasia is currently legal are the Netherlands, Belgium, Luxembourg and Colombia. Assisted dying is legal in Switzerland, Germany, Japan, Canada, and in the US states of Washington, Oregon, Colorado, Vermont, Montana, Washington DC, and California. The idea is that a patient’s life can be terminated on their own request, and that each person who can clearly think for themselves should be able to make this request if they so wish. Or as Philip Nitschke, an Australian humanist and physician who wrote a handbook with practical information on voluntary euthanasia, puts it: “It is a fundamental human right for every adult of sound mind to be able to plan for the end of their life in a way that is reliable, peaceful and at a time of their own choosing.”
“It is hard to know what it is like, to die. But we know what it is like to live. I think we deserve to have control over our own lives until the very end.”
Lately whenever I speak to someone who asks my advice on how to deal with the nearing death of a loved one, I tend to feel a strong urgency to point them towards euthanasia. To inform them about the possibilities in the hopes that they will be able to discuss this with their family, if they haven’t already. The difficulty in this for me is that although I only wish to help others by talking about the options of reducing suffering, I am also aware that by saying this, I am fully confirming the inevitable: death itself. I am not giving them any comforting or soothing well wishes, but I am pointing at the end of their loved ones journey, or worse: suggesting they end it sooner.
But no matter how harsh this seems, I feel it is the best advice I have to give anyone who is terminal and dying. Let me share my reasons for this with you.
My father was eighty-three when he died, almost ten years ago as I am writing this. He had a number of physical conditions: heart disease, diabetes, high blood pressure, etc. A year before his death his doctor discovered a brain tumor, which worsened everything because the tumor was pressing on parts of his brain and resulted in dementia. As his body started deteriorating further, so did his mind. When my mother could no longer take care of him at home, she decided it was time to put him in a nursing home.
She called me one day to ask if I could come over to read the consignment letter for the nursing home and sign it for them. My mother was semi-illiterate and could not read or write very well herself. On my way to my parents house I felt very uncomfortable about the situation. I remembered the countless times my father used to say he would rather die, than end up in a nursing home. But I also knew my mother was at her wit’s end and could no longer give my father the care he needed. I considered giving up my job and study and taking care of my dad myself, but every scenario I came up with seemed impossible. It was heartbreaking. My mother reassured me that this was the best option for all of us. While I signed the papers, it felt like I was signing my dad’s death sentence.
Once he was in the nursing home, his condition drastically worsened. When you think of old people in these kind of places, you see them hang out in front of a TV watching shows together, you see them read books, eat shitty food they endlessly complain about, you see them smile at their children and grand children when they visit. None of this applied to my father’s reality. His lust for life had totally vanished. Back when he still lived at home his biggest passion was reading. He read numerous books, all day every day. But no matter which books we brought him, he just put them on a pile in a corner of his room and never touched them again.
He had quit smoking a few years prior to this, but took on this addiction again once he was at the nursing home. And by smoking I mean chain smoking. I would visit him almost every day and in the beginning I would bring him books, newspapers, his favorite food. But as the weeks went on, these items changed into packages of tobacco and cigarettes. I had quit smoking myself for some time but started again, just so that I could smoke together with him. Smoking was the only thing he wanted to do, not only because he enjoyed it – but mostly because he knew it would make his body weaker and allow him to die sooner. At some point he would not even be bothered to go outside anymore to smoke. He would just sit inside his room, in his wheelchair, with a blank stare, chain smoking.
“If I had been able to give him access to a medicine that would put him in an eternal sleep, I know for certain he would have thanked me, kissed me goodbye, and taken it the minute I walked out the door.”
I should note that no one was allowed to smoke inside the building. But it seemed like the nurses did not care. He was like a kid, taking hard drugs in a class room, and the teachers pretending not to notice. It was a shitty place, and my father would often complain about the lack of care he got there. One day he fell out of his bed, broke his hip, and had to go into surgery which eventually caused him to die due to complications a few days after the operation. Pneumonia to be exact. All that smoking had damaged his lungs sufficiently to cause his death.
This was back in 2009. I have no idea if any if his doctors ever offered him the option of euthanasia, but I doubt it. His was a slow decline into death. He was old, he got sicker, until he died. But if I had the information then that I have now, I could have assisted him a whole lot better, and helped him die the dignified death that he deserved.
If his doctor would not have judged him qualified or sick enough for euthanasia, I could have given my father the information on how to do this himself. If I had been able to give him access to a medicine that would put him in an eternal sleep, I know for certain he would have thanked me, kissed me goodbye, and taken it the minute I walked out the door. Instead, he suffered for at least a whole year, against his will.
During the past decade I have witnessed many other loved ones die. Some deaths seem natural and almost easy, while others seem extremely painful and difficult. It is hard to know what it is like, to die. But we know what it is like to live. I think we deserve to have control over our own lives until the very end.
In our modern world where we are so socially and medically advanced, wouldn’t it be the next step in our evolution to eliminate suffering? By providing information on euthanasia and giving people the option to say when it’s enough. Euthanasia is not for everyone, and it doesn’t have to be. But I believe it should be a choice, and a human right, instead of a privilege or worse, something illegal and taboo.
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Thanks for this piece, sharing your experience. I’m looking at my grandparents in their last stages and there has been a long thread of completed life
Exit strategies for about a decade and now it seems more relevant as one died, one is fading and another wants a exit strategy