What it's like to help someone die

Terminally ill Diane Pretty - who has since died - and her husband, Brian

Here Rob Jonquière, a retired Dutch doctor, reflects in our weekly Real Time series on a patient who asked him to end her life.

I have twice helped patients to die. This was at the beginning of the 1980s, so it was still very punishable. Like many doctors, I reported the cause of death to the authorities as 'natural'.

Rob Jonquière: Joined the pro-euthanasia movement

Both were patients with terminal cancer. Pain was a factor, but maybe even more importantly for one, she was a nurse who was used to looking after people. She thought it unacceptable for her to be completely dependent on others.

She was 52 when she died. In earlier days, she had had Hodgkin's disease which was cured, and then she developed breast cancer which was cured, and after that she had ovarian cancer.

When the doctor told her he could not cure her this time, she raised the issue of assisted suicide with me. I had been her family doctor for many years; I had accompanied her on her way through all these medical problems, so she knew me very well and that's why she dared to talk to me about it.

Long and considered process

We had spoken about her condition many times. If you talk about that - and neither of us was shy to give death its name - you talk about the fact that the end is near.

Law in the Netherlands

Suffering must be continuous and unbearable

Patient has to be of sound mind

Doctor must get second opinion

Lethal drug can only be given by doctor - family cannot help

Law takes effect 1 January

For months, we talked about what to do. Eventually she described the situation in which she wanted to have euthanasia.

At first she said her limit was the moment she could not get out of bed, could not get herself to the toilet. Once that moment arrived, she said, 'Now I'm here, I want to wait a little longer'. I think she realised that others could care for her, and that it meant something to them to do so.

She set new limits, and again she shifted, maybe three or four times in all.

"She wanted snowdrops by her bed"

Her last limit was quite symbolic. She saw some snowdrops coming out in the garden outside her window, and said, 'Once more, I want to have a bunch of those flowers at my bedside.'

She told me then that because she knew I would help her if it was too bad in the end, it had made it possible for her to shift her limits, to live a little longer. The fear of unbearable suffering was worse than the suffering itself.

The time comes

The morning after those snowdrops were by her bed, I got a phone call from her partner to say that she wanted euthanasia. I hesitated, a bit frightened that I had to do it at last, and said that I would be there once I'd seen my other patients.

She told me that because she knew I would help her, it had made it possible to live a little longer

Five minutes later, her minister phoned and said, 'Bev says now - if she says now, it's now.'

We gathered around her bedside - her partner, the reverend and I - to talk and say goodbye. She knew what was going to happen, and again she told me that this was what she wanted.

I administered first a large dose of sleeping pills and she drifted into a deep sleep. After five minutes, I gave her a muscle relaxant which lames the breathing apparatus and the heart - this is the way we do it still. Her breathing stopped, her heart stopped and she died quietly a few minutes later.

My reaction was a complex one - a sadness at losing a friend, but also a feeling of content. I had been able to give her the last thing she wanted, which was help to die peacefully.

It was an utterly criminal act then. But I did not feel that I had committed a crime - I had done something good for somebody.

Dr Rob Jonquière is the director of the main pro-euthanasia lobby in the Netherlands, the Dutch Voluntary Euthanasia Society.

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