Whose life is it anyway?
2011/12/04 - 14:16
“Euthanasia is not a choice between life and death, but the choice between two different ways of dying” — Jacques Pohier
Euthanasia, if allowed by the law, should never become an answer to failing care or fear of loneliness.
A case story by Aycke Smook, MD, Surgeon-Oncologist, The Netherlands
“My personal experience follows more or less the progress in thinking about how to deal with patients in their final stage of life. My motivation to help patients to die has always been the patient’s longing for a dignified death. In the beginning of my practice, I performed aid-in-dying behind closed doors. We, the nurses and I, performed euthanasia according to guidelines that later became the standard. We just helped the patient who begged for ending his hopeless situation. Amazingly, pain hardly ever was the reason for the request for euthanasia. It was always the loss of dignity. In many cases, the desired death was a better perspective for the patient than enduring the misery of the sickbed. The ward’s head nurse assisted me in those early years to inject potassium chloride intravenously together with an overdose of morphine. We knew that the injected substances could not be traced in post-mortem examinations. Afterwards we notified the family of a sudden and unexpected death.
From 1985 onwards we could discuss euthanasia more openly to the benefit of all involved.
For the patient, the relatives, and the friends a fond farewell became possible and the process of mourning could begin before the inescapable death. We now know that an injection of large doses of potassium chloride was not very human. For proper euthanasia we use at present pentobarbital sodium or propofol with a muscle relaxant. Injecting the lethal drug is, without exception, a very emotional event for all concerned, but fortunately, these emotions can now be shared. For me it was the end of a long and stressful period, but also a relief. An attending doctor should never let his patient down in the last vulnerable phase of his existence. Performing euthanasia changed from a careful but sneaky process in the past to a dignified act for a patient to pass away amidst his/her family. It is amazing to see the power of patients in their final stage. In most cases, they support the future surviving relatives instead of the other way around, and the process of mourning starts beforehand. It is also remarkable that in the end many patients abandon their morphine medication in order to stay “captain on their own ship” and to have a clear mind at the moment of their farewell. Very impressive was a lady of 76 who was in full control of her last hours. She had a word for each of her children, children in law, grandchildren, and she supported her husband in grief. She thanked me and the nurse for our willingness to give her the last medication. She herself turned the tab of her IV drip and passed away in dignity with a smile on her face, surrounded by her family.
- Contributed by Jacqueline Jencquel, News Editor, 13 August 2008
Euthanasia, if allowed by the law, should never become an answer to failing care or fear of loneliness.
A case story by Aycke Smook, MD, Surgeon-Oncologist, The Netherlands
“My personal experience follows more or less the progress in thinking about how to deal with patients in their final stage of life. My motivation to help patients to die has always been the patient’s longing for a dignified death. In the beginning of my practice, I performed aid-in-dying behind closed doors. We, the nurses and I, performed euthanasia according to guidelines that later became the standard. We just helped the patient who begged for ending his hopeless situation. Amazingly, pain hardly ever was the reason for the request for euthanasia. It was always the loss of dignity. In many cases, the desired death was a better perspective for the patient than enduring the misery of the sickbed. The ward’s head nurse assisted me in those early years to inject potassium chloride intravenously together with an overdose of morphine. We knew that the injected substances could not be traced in post-mortem examinations. Afterwards we notified the family of a sudden and unexpected death.
From 1985 onwards we could discuss euthanasia more openly to the benefit of all involved.
For the patient, the relatives, and the friends a fond farewell became possible and the process of mourning could begin before the inescapable death. We now know that an injection of large doses of potassium chloride was not very human. For proper euthanasia we use at present pentobarbital sodium or propofol with a muscle relaxant. Injecting the lethal drug is, without exception, a very emotional event for all concerned, but fortunately, these emotions can now be shared. For me it was the end of a long and stressful period, but also a relief. An attending doctor should never let his patient down in the last vulnerable phase of his existence. Performing euthanasia changed from a careful but sneaky process in the past to a dignified act for a patient to pass away amidst his/her family. It is amazing to see the power of patients in their final stage. In most cases, they support the future surviving relatives instead of the other way around, and the process of mourning starts beforehand. It is also remarkable that in the end many patients abandon their morphine medication in order to stay “captain on their own ship” and to have a clear mind at the moment of their farewell. Very impressive was a lady of 76 who was in full control of her last hours. She had a word for each of her children, children in law, grandchildren, and she supported her husband in grief. She thanked me and the nurse for our willingness to give her the last medication. She herself turned the tab of her IV drip and passed away in dignity with a smile on her face, surrounded by her family.
- Contributed by Jacqueline Jencquel, News Editor, 13 August 2008
