Letters Denial in assisted dying

My experience with euthanasia

BMJ 2011; 343 doi: http://dx.doi.org/10.1136/bmj.d4508 (Published 02 August 2011) Cite this as: BMJ 2011;343:d4508
  1. Allena M Silvius, general practitioner1
  1. 1Leyden, Netherlands
  1. hsilvius{at}xs4all.nl

As a Dutch GP I would like to share my personal experience. In the Netherlands euthanasia and terminal sedation are allowed under very strict rules.1 2

I am experienced in delivering palliative care. I have been asked dozens of times whether I would be prepared to perform euthanasia if there was no other option. I only had to do it twice.

Terminal sedation feels more “natural” because it is performed only if all other options to relieve symptoms fail and life expectancy is less than two weeks. High doses of a sedative (usually midazolam) are given to ensure that the patient is free of pain until nature takes it course.

Although as a doctor I favour euthanasia, as a person I find it hard to perform. It is a great burden on my personal life and causes me extreme stress. The days before I performed my second (and so far last) euthanasia were very emotional. I shifted between enjoying life and extreme sadness that life had nothing to offer my patient that could make up for the suffering she experienced.

There is also the stress of doing it right and waiting to see whether the committee decides you abided by the rules and will not prosecute.

Euthanasia law grants a patient the right to determine what is and is not psychologically and physically bearable. As a doctor I sometimes feel caught between my desire to do well and the fact that I have to be the means to a patient’s self determination.

I wanted to be a doctor to help patients, not to kill them.


Cite this as: BMJ 2011;343:d4508


  • Competing interests: None declared.