Abstract

‘But how is it actually done?’ It was one of those conversations about euthanasia that Dutch physicians are often drawn into when they travel abroad. Each time the struggle is to explain that some individuals – or even societies – set higher value on individual autonomy than on the sanctity of life, and also that the issue has nothing to do with availability of palliative care or, worse, utilitarian notions. This time we were dining in the hall of an English college and my interlocutor was an internist from another European country. ‘Well’, I replied, though sensing that an explanation of technicalities was somehow going to widen rather than narrow the divide, ‘in the same way the vet does it – first an infusion of barbiturates and then of muscle relaxants.’ My colleague said nothing, but the disgust on his face was only too obvious. He seized the earliest opportunity to start a