At the end of April this year, I had a sad experience when I had to euthanize Malice, my feline companion for nine years. I wrote the details of this painful event in an essay, “Euthanasia for Malice”, which I posted on my blog last month. Around that time there was a big debate raging in the Swiss Canton of Zurich, prior to the referendum on the 15th of May, on the future of “assisted suicide” administered by a non-physician who had no vested interest in the death, permitted in the country since 1941.
Assisted suicide came about in respect of the right of an individual who wished to terminate his/her life when suffering unbearable pain from non-curable sickness, such as terminal cancer. A large majority of the Swiss had supported it based on the belief that prolonging one’s life unnecessarily under such conditions was cruel. However, very few countries in the world now allow euthanasia, mercy-killing or assisted suicide (e.g. Holland, Belgium, Luxemburg, the State of Oregon in the U.S.), and there was a growing concern that “suicide tourism” was on the rise among foreigners who would come to Switzerland, seeking it in haste without spending sufficient time for counseling. This concern led to the decision to hold a referendum in the Canton of Zurich. Two questions were asked in the referendum: whether to maintain the status quo and whether to exclude foreigners, even if it was to be maintained. The results showed an overwhelming support for the status quo, — only 15.5 % of the voters wanted to see it banned and a mere 22% thought that foreigners should be excluded. (See http://karapaia.livedoor.biz/archives/52007279.html)
When this debate was being aired in the media, I could not help thinking of my late mother who died 31 years ago at the age of 64 from cancer in the bile duct, the tube that carries bile from the liver and the gallbladder to the duodenum. In those days in Japan, doctors usually did not tell cancer sufferers the real nature of their illness, but explained the details to their families. When we learned about our mother’s medical state, her cancer was already at an advanced stage and had spread to other organs. The doctor therefore decided it was too late to operate on her. He informed us she had only about three months left to live.
In desperation and hoping for a miracle, we did everything possible to help her recover or to somehow prolong her life. For example, we unhesitatingly approved her doctor’s suggestion to try new anti-cancer drugs on her which were still very expensive as they had not yet been covered by the national health insurance. Whenever we obtained information on any item claimed by some people to be effective against cancer, we did our best to obtain it for our mother to drink or eat. I did not know whether these efforts of ours had been worthwhile, but she lasted for six months, instead of three. Nevertheless, during the final three months of her life, she appeared to have constantly suffered extreme pain.
Pain all over her body worsened day by day and she required increasing doses and frequency of morphine injections. After getting a shot of strong pain killer, her blood pressure used to drop to a dangerous level, and I remember seeing a nurse giving her another injection, this time to raise her blood pressure. In this way she kept receiving morphine and the drug to control her blood pressure alternately and more frequently. While visiting her in the hospital, I saw her tethered to a syringe stuck in her arm for many hours that was connected to an intravenous drip containing anti-cancer drugs or nutritional supplements. During the last three weeks of her life, she was attached to so many tubes that she could hardly move any part of her body. For example, there was a tube inserted into her gallbladder to let bile flow out; there were tubes connected to an oxygen inhaler inserted into her nostrils to help her breathe more easily; there was a tube inserted into her stomach through the esophagus to allow abdominal dropsy to flow out to ease her pain; there was a tube inserted into the urethra; and so on. It was so painful to watch her being kept alive that way.
I believed that our mother, having been well aware of her condition and of the fact that there was no chance of recovery, wished for euthanasia. At least, she confided to me the meaninglessness of continuing the treatment, which seemed to her totally futile, while suffering unbearable pain every day. I told my elder sister about her wish, and suggested that we talk the matter over with the doctor. Her reply was that basically the Japanese health care system placed top priority on life-sustaining treatment, and therefore he would be annoyed if we raised any thought contrary to that principle. So that was that. Our mother eventually left us, but only after she had gone through agony and excruciating pain during the final three months of her life.
A regret I have is that I was unable to help her die with dignity, as desired by her. I do not know how much the Japanese medical care system has evolved over the years regarding the question of euthanasia or “death with dignity”, but I suspect not much has changed. A friend of mine in Tokyo told me a couple years ago that she finally regained peace of mind only after the death of her father who had been totally unconscious after suffering a severe cerebral hemorrhage ten years previously and who had been kept alive on life-support machines for many years.
Time flies. In two years I will reach the age at which my mother left this world. We all wish to fulfill our aspirations and reach the end of our lives in good health, without becoming bed-ridden. That is my hope, as well. In the future, however, should I fall sick like my mother did, with no chance of recovery, and should I have to go through excruciating pain as my mother did, I earnestly hope that a system will have been introduced by that time in Japan to enable me to decide, after sufficient counseling, when to terminate my own life.