[bsandert]

From personal experience, I can very much relate to and agree with this piece. My father went through a similar process: cancer (melanoma) – two years of treatment and coming to terms with the facts – euthanasia. As a family, we have been very matter-of-fact about it, which was definitely something he encouraged and participated in. We frequently talked about all aspects of his disease, the future, how it affected him and us. Sometimes one of us sighed that it would have been so much better if he would have suddenly died in his sleep but I always disagreed with that, it would just have come with a different set of emotions and grieving. I am actually very happy that we were able to share parts of this process with each other while he was still around.

The weekend before his death, our house was filled with people who worked up the courage to come say goodbye, he sat among them in the living room and took a few minutes in person with everyone as much as his state allowed. I sat on his bed as he was treated with euthanasia, which was one of the most intense experiences of my life. I still miss the man every day, but because of the process we had together, I have nothing but fond memories of the times he was still there, including the very hard periods of time that come with a disease like this.

This turned into a bit more text than I intended but my point is this: If you ever have a choice in the way you are to die, take heed of the points in this story. It may seem brutal at times to be as honest and open as you can about such an intimate process, but having gone through it once, I have absolutely no regrets. I wish Pieter and his loved ones all the best in the coming times.

[nihonde]

I just spent over a year with someone who died of cancer on Tuesday. I don't know if she would have opted for suicide if it had been legal here, but I do know that the last few weeks were extremely difficult for everyone involved. I have a very clear image of how cancer kills a person now. We did our best to maintain her dignity, but the body is not on your side. It's humbling, to say the least, which is a profound lesson in and of itself.

[entilzha]

I think that euthanasia is very different from suicide. Euthanasia is an acceptance of very probable death in a way that reduces both the person's suffering, but also the suffering of those who love them (much as the beautifully written articles talks about). Suicide in contrast can devastate the lives of the people who loved them.

[throwaway324324]

No, that's not euthanasia. On that account, sedation without death would count. Euthanasia is when you ask (or in some cases, force, against their conscience) someone to kill you. Compare with "suicide by cop".

We are going to die. Some of us are going to die on the street after decades of physical pain, alienation, emotional abandonment, mental illness, and alcoholism/drug abuse. Many of these have less true hope for a good life than a cancer patient like Pieter, but it would be insane if there were dozens of comments lamenting the lack of voluntary suicide services in homeless shelters (though maybe we're a bit sensitive about that sort of thing not working out too well the last time we tried it).

Humans have something that puts us above being put down like an animal. And we have to suffer for it - like we do for many of the other things that make us human.

[PieterH]

This is not accurate. Euthanasia in Belgium (as in all countries where it's a legal act) has nothing to do with suicide and everything to do with removing pain and criminality from what is a fairly widespread act.

* Doctors who wish to help their suffering patients can do so without fear of criminal prosecution.

* Terminal patients can control their own deaths without family demanding expensive, painful treatments that have little or no chance of success.

* Such patients are protected from punishments such as loss of insurance.

* Family and friends can be shielded from extended stress and trauma.

Given that cancer is a majority cause of death in the West, and tends to be incurable in most cases, and tends to lead to massive suffering, euthanasia is IMO one of the most fundamental human rights.

You are of course free to reject such a course based on your own beliefs. However to argue that suffering and pain are the cost of being human is... invalid.

[throwaway324324]

I think we at least agree on suicide. Suicide is a desperate act: we must feel deep sympathy for its victims and contempt for its promotion. But what you plan to undertake - euthanasia - is not suicide, but just something that reduces pain, stress, and financial loss.

Those are the goals, but to attain them you plan to ask someone to sedate you and then kill you by stopping your heart. The evil of suicide isn't that it's a violent or unexpected death, but that it is a planned death, the victim trading her life for benefits like reduced suffering (or in even sadder cases, life insurance payoffs, a ufo trip, honor for the emperor, whatever). The person's remaining life seems worthless, so they plan, make their decision, feel at peace and begin to put their affairs in order - I read this in a "suicide prevention" pamphlet. Please tell me what the difference is to you, since I no longer have the opportunity to ask someone in that position. I see the following answers:

* It is not suicide because I really am better off dead.

* It is not suicide because numerous doctors judge that I really am better off dead.

* It is not suicide because cancer is worse than depression and an injection is better than a rope.

* It is not suicide because my loved ones also feel at peace with my decision.

Can you tell me plainly how what you plan is different from suicide?

And sure, I agree that humans are rational animals, not suffering animals. But the world is not perfect, so there are still some times where we must endure even intense suffering to maintain our human dignity. You are fortunate enough to have access to sedation until natural death, why not take advantage of that instead?

[jawilson2]

Out of curiosity do you live in the US?

[bsandert]

I am from the Netherlands. Euthanasia is legal here, although strictly regulated (as I think it should be by the way, this is not the sort of choice that should be taken or approved lightly by anyone involved). Several doctors had to sign off on it, and they were thorough in making sure that this was his decision alone and that nobody around him was "pushing" him into it. Fortunately (if you can call it that), his medical situation was a textbook case of unbearable and hopeless suffering, and also he still had a clear enough mind to express his wishes. That made the approval process fairly straightforward in his case.

[throwaway324324]

For those wondering what the typical regulations consist of, I found the following article doing a quick google search:

>> In all jurisdictions, the request for euthanasia or pas has to be voluntary, well-considered, informed, and persistent over time. The requesting person must provide explicit written consent and must be competent at the time the request is made. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3070710/

This is fairly comprehensive, which is reassuring. However, the article goes on to say:

>> Despite those safeguards, more than 500 people in the Netherlands are euthanized involuntarily every year. In 2005, a total of 2410 deaths by euthanasia or pas [physician assisted suicide] were reported, representing 1.7% of all deaths in the Netherlands. More than 560 people (0.4% of all deaths) were administered lethal substances without having given explicit consent. For every 5 people euthanized, 1 is euthanized without having given explicit consent.

Just because regulations are strict, does not mean that they are strictly followed, or enforced.

[mjevans]

It would be relevant to know, of the 'involuntary' numbers, how many of those were statutory involuntary and for what reasons.

My hope is that in the majority of those cases the paperwork either just didn't get finished in time, or that the subject in some way did actually want this but started the process too late to be clearly of their own decision.

[Someone]

Reading the PDF (http://www.nejm.org/doi/pdf/10.1056/nejmsa071143):

"When life was ended without the explicit request of the patient, there had been discussion about the act or a previous wish of the patient for the act in 60.0% of patients, as compared with 26.5% in 2001. In 2005, the ending of life was not discussed with patients because they were unconscious (10.4%) or incompetent owing to young age (14.4%) or because of other factors (15.3%). Of all cases of the ending of life in 2005 without an explicit request by the patient, 80.9% had been discussed with relatives. In 65.3% of cases, the physician had discussed the decision with one or more colleagues"

So, part of this is due to the fact that the law states that doctors must check that the patient consents _now_ with the choice. A written statement that, for example, one doesn't want to live on with Alzheimer's when one has reached a well-described state is not sufficient.

[throwaway324324]

So you're essentially hoping that these people, who did not give explicit consent, actually (and perhaps secretly) did want to be killed?

My hope is that where paperwork did go through, no person was uncertain or regretted their life-altering decision (which, for example, increases suicide risk in one's family twofold). But I doubt that either of our hopes lives up to reality.

[mercurial]

> increases suicide risk in one's family twofold

Euthanasia increases suicide risks as opposed to dying painfully of natural causes?

[robryk]

> increases suicide risk in one's family twofold

What is the baseline here? Could you provide a source?

[sp332]

The twitter account in bsander's profile says Amsterdam.

[paxcoder]

Revolting. I protest against suicide, the "assistance", the approval, and the very idea that it could somehow be eu (good).

[Ironchefpython]

That's an opinion that is perfectly valid for an individual to have.

However, when you express this opinion in an expressly negative way, it makes it sound like you are attempting to invalidate the opinions of people who might hold contrasting beliefs. And history has shown this to be one of the top 10 causes for conflict and wars.

Perhaps you might find a more positive way to express your personal beliefs? Perhaps you could say, "I wish we lived in a world without pain or terminal illness, so nobody would have to make the choice between pointless suffering and death".

If you find some way to contribute to the conversation without calling a man dying of cancer "revolting", you would have a better chance of finding common ground and reaching consensus.

[throwaway324324]

To disagree is to try to invalidate contrasting beliefs. They aren't saying "people who commit suicide are revolting", nor "I wish we never had to make tough choices that tested our moral constitution" (like you suggest). They're saying "saccharine suicide-endorsement is revolting".

There's no consensus arising from softening and "adjusting" each other's views. We're better off describing things clearly.

What is euthanasia, except killing yourself because you have no hope for your remaining life, like every other suicide? Is it justified because you had your family and your doctor agree with you?

[Retric]

I suspect you vastly underestimate the suffering in the last few weeks of cancer. you are literally being slowly eaten alive until there is not enough left to keep up basic bodily functions and pain medications generally stop being effective. You can be in chemical induced sleep or unimaginable pain.

[admnor]

Luckily, nobody cares what you think.