Alleged euthanasia involving ALS patient must not be repeated

Doctors’ proper duty is to help their patients live better lives. If their actions are just an easy way to hasten death, this is a deviation from the field of medicine and should not be tolerated.

Two doctors have been arrested by the Kyoto prefectural police on suspicion of murdering a woman at her request through the administration of drugs, as she suffered from amyotrophic lateral sclerosis, an incurable disease in which patients lose control of most of their body’s muscles.

The woman and one of the doctors reportedly met through social media, on which she had repeatedly posted that she was seeking euthanasia. The doctor had also expressed opinions on social media in support of euthanasia. The two are believed to have communicated online for nearly a year without ever meeting in person during that time.

Could the doctor really understand the woman’s emotions, as he communicated with her through social media alone? She wrote on social media that she wanted to die, but he was not her doctor and had not treated her.

It is said that ¥1.3 million was transferred by the woman to the doctors. If this was compensation for the risk involved in drug administration, the conclusion would be that they performed a short-sighted act despite knowing it was illegal. These questions cannot be dismissed.

The use of drugs to hasten a patient’s death is called “active euthanasia” and is basically not allowed in Japan. However, the Yokohama District Court set out some conditions to allow it in exceptional cases when it ruled that a doctor at Tokai University Hospital was guilty of murder.

There were four conditions: (1) The patient is suffering from intolerable physical pain; (2) Their death is inevitable and imminent; (3) There are no alternative measures for relieving or alleviating the physical pain; and (4) The patient shows a clear desire to die.

The prefectural police may have concluded that the latest case did not fulfill these conditions because, for example, the woman was not near death.

Some countries, including the Netherlands and Belgium, have legalized euthanasia, but with conditions similar to these four requirements. It is only natural that the choice of death should require careful consideration.

It is doubtful that the doctors engaged in much consideration, as before the incident, they put up casual posts such as, “We’ll need a far better plan than one that might appear in Conan and Kindaichi,” citing the titles of popular comic books about detectives.

There are many people living with ALS and other incurable diseases. Some such patients have said that they do not want their lives to be rejected. As ALS progresses, it can become difficult to talk, eat or even breathe. No fundamental treatment has been established, and the suffering of the patients is hard to imagine.

Before she died, the woman wrote that she was deeply miserable because she could not move a single finger. It is necessary to create an environment that does not isolate patients, but this approach by the two doctors is not going to solve the problem.