Sometimes a person reaches a point in life where living becomes meaningless or even unbearable. This often follows the diagnosis of an incurable disease or injury, that results in loss of health or functionality, along with constant pain. These medical conditions may become a reason for a decision to voluntarily pass away.
Euthanasia is a medical procedure in which:
- medical intervention, aimed at maintaining a patient’s life, is terminated according to his or her request (passive euthanasia), or
- a drug is used for instant and painless death (active euthanasia).
From this article, you will learn about the reasons that make people seek assistance in dying, the indications for euthanasia and the other options for those suffering from end-stage or hard-to-treat diseases.
Euthanasia as a legal suicide
In some cases, medicine can help patients to end their lives through euthanasia or physician-assisted suicide (PAS). Currently, these two procedures are officially banned in most countries, with the exception of Belgium, Luxembourg, Canada, Spain, the Netherlands, and some others. Switzerland is one of those locations where it is legal to use the help of a doctor for voluntary death, for both citizens of the country itself and citizens of other countries.
The main conditions are that it must be voluntary, the patient must be aware of the irreversibility of the procedure, alternative care must be either ineffective or refused by the patient, and expert medical assessment of the patient’s case must be undertaken. The whole process can drag on for many months. In addition, the cost of euthanasia can reach €4,000, although a number of pharmacists may distribute deadly drugs illegally for less (with no guarantee).
Despite this, in 2020, in Switzerland alone, 221 people used the right to euthanasia, with most of the foreign patients (84 people) coming from Germany.
What makes patients choose euthanasia?
It is a very brave decision to take responsibility not only for your life but also for your death. Although the decision to end one’s life may seem controversial, no one has the right to condemn another person for such a choice. This choice may be associated with a deterioration in a person’s quality of life due to a medical condition that causes suffering. In the context of euthanasia, these medical conditions are most often:
- psychiatric disorders;
- being in the final stages of incurable physical illnesses, such as multiple sclerosis, Alzheimer’s disease, amyotrophic lateral sclerosis (ALS);
- cancer in the terminal stage;
- paralysis; and some more.
For some patients, death is imminent as, for example, in the case of those with end-stage disease. For them, even with the best and most professional palliative care, it is not always possible to eliminate all the suffering they may face.
In other cases, the desire to end one’s life may be dictated rather by a psychological state. For example, a patient with a disease or injury, who cannot come to terms with the need to abandon the usual activities and previous goals, may not wish to continue living. The need to change the social circle, adapt to a new way of life and put up with limitations due to the state of health, may seem too much to bear.
A clear awareness of what will take place on the last day makes it possible to observe the ritual of saying goodbye to life and to loved ones and to prepare mentally and physically for leaving. When you know exactly the moment that it will happen, this eliminates the anxiety associated with waiting. It also gives you a sense of control in the last segment of life, and the opportunity to end on a positive note while, at the same time, taking into consideration the feelings of your loved ones. A conscious end to life for a suffering patient may bring long-awaited and desired relief and is an opportunity to gain, even in death, a sense of control. In addition, it prevents the stretching out of time during the trauma associated with the inevitable departure. This also may be considered as taking care of a patient’s loved ones when he or she leaves in peace, with relatives mentally prepared for this death.
What are the options for a patient seeking euthanasia?
Having made the decision to pass away voluntarily, patients turn to specialized clinics for approval of their case. At Swiss Medica, two options may be available.
- If you have a request for euthanasia, please contact our medical advisor. The Clinic’s doctors will assess your medical reports to evaluate your case.
- If you have already submitted a request for euthanasia in one of the facilities, then you still have time left to spend at your discretion. While you are waiting for approval of your case you could try, as a last-hope therapy, stem cell treatment, which can alleviate symptoms in many medical conditions, depending on the diagnosis.
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“I’d like to have a choice.” The story of a patient seeking assisted dying
Luca N., a 57-year-old patient from Germany, had two strokes, one in 2016 and the other in 2019. Since then, he has lived in a nursing home, where he receives the necessary medical care. But the destruction caused by the strokes has affected too many areas of his life, and this made him think about voluntarily ending his life. Enlisting the support of relatives, he was able to tell his story.
“When I had my first stroke, it took me by surprise. I still look in the mirror and can’t believe that the Luca I was before the stroke, and the current me, is the same person. I had a fairly successful business, I travelled a lot, and my social circle was huge. Now I am unable to move on my own, my left arm does not obey me, I have problems swallowing and it is difficult for me to speak. It was like I drove into a wall at full speed. This broke me, mentally and physically. I just can’t find new meanings in this new reality of mine. And I realize that it’s not for me anymore.
They say it’s wrong to end your own life. But is this a life? They also say that you need to believe in the best. But my faith does not stand up to a duel with common sense. I know I’ll never be able to go back to the days when I was completely healthy, and that’s the truth. A few improvements are my only possible hope.
I wasn’t asked if I wanted to have a stroke. It wasn’t my choice. I didn’t give my consent to this. And now I just want to regain my right to dispose of my life as I see fit. I can no longer manage my life as I could before, but at least I can manage my death, and through this decision about euthanasia I can regain a sense of control over my life. I want to have a choice this time. And I want others to know how important it is for us, people without hope in their condition, to have this choice.
When I realized that my condition is till the end of my life, I began to learn about voluntary death. I’d like to get help in assisted dying. It’s not something I’m going to rush with, but I just know that, sooner or later, I’m going to do it. I have already applied to a medical institution, and I have some bureaucratic procedures ahead of me. I hope they approve me. Of course, it will take time; in the experience of others in the same situation, quite a lot of time. Maybe I can still attend a couple of family holidays. Although it is quite painful for me now.
I was also told about stem cells, which can treat stroke damage and improve the condition. It’s like they can reduce the symptoms, make me more energetic and all that. Maybe I’ll try them too, just to be sure that I got everything I could for myself. So to speak, to ease the pangs of conscience. I can’t call myself a religious person, so that’s not the point. I decided to do this mainly because of my children. Although they have been adults and independent for a long time, the fact is that their mother died at a fairly early age and, it turns out, I’m also going to leave them. Perhaps this is not good.
So I’ll try these cells, probably. A friend of mine was undergoing such therapy and said that he became more active and could do more different things. Well, although this is far from a full recovery, I would also like to regain some of my functions, at least for as long as I remain alive while waiting for my turn to heaven.”
Stem cells as a last-hope therapy*
Some diseases, that are considered incurable from the point of view of conventional medicine, may show a positive result when treated using less common methods. In particular, this is true for regenerative therapy, in which stem cells are used. It has been proven that mesenchymal stem cells are beneficial in the treatment of diseases such as multiple sclerosis, strokes, dementia, chronic pain syndrome, and many others.
Cell therapy in severe diseases is, of course, not able to cure the patient completely, but it is able to make it possible to live without painful sensations, to restore lost functions partially, and to improve the quality of life to a tolerable level. This, in turn, allows a patient to delay the moment when, due to the state of health, the meaning of life is completely lost. Thus, regenerative medicine gives a chance to prolong life and increase its quality due to the following effects:
- rejuvenation of the body (increased energy levels, improved well-being, increased immunity, blood pressure normalization);
- improvement of symptoms in a number of diseases (neurodegenerative, neuromuscular, autoimmune, age-related diseases);
- reduction of pain syndrome;
- improvement in cognitive functions.
Why keep on living?
Many patients refuse to accept their new reality after injury or serious illness and wish to receive euthanasia services. However, there are things that people believe may keep them on this planet, despite their condition. These include:
- unfinished business that may be important to the dying person or to those close to him or her;
- the desire to extend the time spent with loved ones, to delay for them the inevitable experience of loss, to prepare them mentally for this event;
- the need to fulfil some obligations or dreams, or create some important circumstances that are possible only with the patient’s personal participation or presence;
- the need to find new meanings, to realize or revise the patient’s personal story of life, to fill his or her soul with forgiveness and love before leaving.
It so happens that sometimes we do not need ourselves, but we are needed by our loved ones or those who depend on us. Or, perhaps, something important in this world depends on our participation and presence here, which can affect the lives of other people. Therefore, sometimes we have to delay.
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Medical Advisor, Swiss Medica doctor