We must tell the whole truth: Response to: There is nothing holy about agony: religious people and leaders support assisted dying too
Dear Editor,
It is not possible for modern medicine to guarantee a smooth, pain free, suffering/agony free, dignified natural or intentional death for all.
The characteristics and frequency of clinical problems with the performance of the intentional killing of a human being ( e.g. euthanasia and assisted suicide) are rarely discussed. The public, politicians and many professionals may not be aware of the possibility of complications and/or failure during the procedure to intentionally end a human life.
For all forms of ‘assisted dying’, there appears to be a relatively high incidence of vomiting (up to 10%), prolongation of death (up to 7 days), and re-awakening from coma (up to 4%), constituting failure of unconsciousness (1).
In the Netherlands, complications occurred in 7 percent of cases of assisted suicide, and problems with completion (a longer-than-expected time to death, failure to induce coma, or induction of coma followed by awakening of the patient) occurred in 16 percent of the cases; complications and problems with completion occurred in 3 percent and 6 percent of cases of euthanasia, respectively (2). The physician decided to administer a lethal medication in 21 of the cases of assisted suicide (18 percent), which thus became cases of euthanasia.
It is important the debate on this grave matter includes public discussion of the many clinical (e.g. above), technical ( e.g. difficulty finding suitable veins) and other problems (e.g. availability of lethal medications) that arise that may prevent the intentional death being dignified, agony/pain free etc.
A truthful debate requires all the facts.
1.Sinmyee, S., et al., Legal and ethical implications of defining an optimum means of achieving unconsciousness in assisted dying. Anaesthesia, 2019. 74(5): p. 630-637.
2. Groenewoud, J.H., et al., Clinical problems with the performance of euthanasia and physician-assisted suicide in The Netherlands. N Engl J Med, 2000. 342(8): p. 551-6.
Rapid Response:
We must tell the whole truth: Response to: There is nothing holy about agony: religious people and leaders support assisted dying too
Dear Editor,
It is not possible for modern medicine to guarantee a smooth, pain free, suffering/agony free, dignified natural or intentional death for all.
The characteristics and frequency of clinical problems with the performance of the intentional killing of a human being ( e.g. euthanasia and assisted suicide) are rarely discussed. The public, politicians and many professionals may not be aware of the possibility of complications and/or failure during the procedure to intentionally end a human life.
For all forms of ‘assisted dying’, there appears to be a relatively high incidence of vomiting (up to 10%), prolongation of death (up to 7 days), and re-awakening from coma (up to 4%), constituting failure of unconsciousness (1).
In the Netherlands, complications occurred in 7 percent of cases of assisted suicide, and problems with completion (a longer-than-expected time to death, failure to induce coma, or induction of coma followed by awakening of the patient) occurred in 16 percent of the cases; complications and problems with completion occurred in 3 percent and 6 percent of cases of euthanasia, respectively (2). The physician decided to administer a lethal medication in 21 of the cases of assisted suicide (18 percent), which thus became cases of euthanasia.
It is important the debate on this grave matter includes public discussion of the many clinical (e.g. above), technical ( e.g. difficulty finding suitable veins) and other problems (e.g. availability of lethal medications) that arise that may prevent the intentional death being dignified, agony/pain free etc.
A truthful debate requires all the facts.
1.Sinmyee, S., et al., Legal and ethical implications of defining an optimum means of achieving unconsciousness in assisted dying. Anaesthesia, 2019. 74(5): p. 630-637.
2. Groenewoud, J.H., et al., Clinical problems with the performance of euthanasia and physician-assisted suicide in The Netherlands. N Engl J Med, 2000. 342(8): p. 551-6.
Competing interests: No competing interests