It’s often a certain type of person. Highly educated, friendly, about 60 – and very assertive. They are well prepared come to meet them, sometimes their papers are already with them. Because before they finally choose me as their new doctor, they first want to talk to me about euthanasia.
I understand polling for euthanasia. They want to avoid getting into a situation where they struggle so hard and then find out that their doctor doesn’t want to help them. And then, sick and well, he must go shopping for euthanasia. At the same time, I find it uncomfortable to enter into a medical-ethical debate with healthy 60-year-olds about their future and often still on their virtual deathbed. Plus, I regularly feel that people feel they have the “right” to euthanasia – and I have an obligation to euthanasia. This euthanasia is a claimable right, if you have ever delivered a declaration of euthanasia.
I find the most complex questions about my position on euthanasia in dementia. People with dementia can suffer greatly from their disease. But healthy people often report that they want euthanasia once they lose control of themselves due to dementia. They want to live as long as they can indicate that they want euthanasia, but as soon as they can’t say they want euthanasia. But then as a doctor I don’t want to do that anymore.
Because we know that views change. People with cancer sometimes say: If I become bedridden/in a lot of pain/become dependent, I don’t want to anymore. They expect that they will no longer live as meaningful and tolerable. This is not often true. There are other things of value: music, hugs, enjoying a bird on the balcony. Man is a flexible and flexible being. Can a person who is not insane decide for himself when life is no longer worth living for his insane person later?
Part of the suffering of people with dementia is feeling conscious of losing control of life. To what extent is a person who cannot indicate that they want euthanasia because of dementia still aware of their condition? How much does someone still suffer?
In the Netherlands, anyone in hopeless suffering can request euthanasia, but the majority of those who are dying do not choose to. It is, rightly, a very individual choice.
It is also an individual choice for clinicians whether and when to perform euthanasia. Euthanasia is incredibly unfair to a doctor, too. It is one of the most intimate, meaningful and rewarding parts of my job as a general practitioner, but at the same time it is very heavy. Euthanasia is not an ordinary medical act. As a physician, I have to judge and feel as a human that it is right, that the other suffers unbearably, hopelessly, and is ready to die. Because I have to keep knowing that someone died before because of me.
Euthanasia is not really a patient’s right. Euthanasia is not obligatory for the doctor. Euthanasia is the worst and most beautiful gift a doctor can give you.
Rinske van de Goor General Practitioner
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