Social and existential problems tip people over the edge
Most requests for euthanasia in the Netherlands come from people suffering from cancer. But the number of patients who have dementia, psychiatric disorders, or multiple geriatric syndromes (MGS) is growing steadily.
An article by Dutch physicians in JAMA Internal Medicine examines the kind of geriatric syndromes which motivate a person to ask for euthanasia.
They found that an accumulation of geriatric syndromes alone is insufficient to explain the unbearableness of suffering that leads to a request for euthanasia. All of the patients they studied had been suffering from MGS for several years. But then came a tipping point – a fall, an infection, a hospitalization, or the loss of a close relative. Falls can often prompt a reflection on life, warning of a future of decline, dependence and isolation.
It was this combination of aches and pains in conjunction with the medical history, life history, personality, and values that gave rise to what the patient experienced as unbearable suffering.
Their finding also may also explain why, in some exceptional cases, the medical dimension of the suffering can also be based on a single geriatric syndrome that, in combination with social and existential problems associated with that syndrome, may result in unbearable suffering.
In summary, experiences in the social and existential dimensions are intertwined with the medical dimension of suffering.
Michael Cook is editor of BioEdge
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