Hi there! Well, I usually write about something fun, mainly travel and culture in Japan, however, I just want to pick up a bit controversial and shocking topic this time. It is about how to end your life journey in case you have suffered from incurable illnesses. One of the coping measures is euthanasia and I came across the chance to think about it very deeply lately.

Thinking about how to terminate your life by your choice under incurable illness

It was a TV documentary program aired on NHK (it is the major TV station in Japan) last month, which was about the story of a Japanese single lady in the middle-age who had suffered from incurable illness called “Multiple system atrophy” for several years. The program followed her rest of life for a few months from when she chose euthanasia until the last moment which she passed away in Switzerland while being watched over by her sisters. She became the first Japanese to execute euthanasia with a support from the Swiss association called “Life Circle” which assists suicide. Additionally, the book about her euthanasia written by a Japanese journalist has also been published soon after broadcasting the program on TV, so the issue got into the news in Japanese society.

The illness which she suffered was relatively serious and haven’t found any effective treatments yet. The patients are slowly, but steadily losing their physical functions, such as moving, speaking, eating and even breathing by themselves in the near future. After being bedridden, they cannot live without supporting by family members and/or cares, as well as some medical equipment like a respirator. I cannot help but say that it is very severe situation both for patients themselves and people around them.

The Japanese lady went back to her hometown after revealing her illness in order to live together with one of her sisters, and she was so distressed and feared about her future because it had only increased what she could not do. In particular, she was a very independent woman with professional skills before suffering the illness and had done everything around her by herself . Therefore, it was not what she want to do that she keeps living for all her life left after being bedridden with equipping a respirator and supporting by others even it is her sisters. Besides, she wanted to end her life before losing true self, so she tried to commit suicide several times behind her sister’s back, but she failed all times due to her physical weakness. Meanwhile, her sisters were also really anxious about her not only physical but also mental conditions because she completely lost her zest of living.

One day, she alighted on the book about the reportage of euthanasia in European countries written by a Japanese journalist and knew that Switzerland was a legal country of euthanasia and it is only one which accepts not only for Swiss but foreign applicants in the world. As you know, euthanasia is not legalized in Japan, so that you have to resister your name on some associations which provide support for your euthanasia and you have to go there if you really want to carry out it. (Strictly speaking, they are assisting someone’s suicide. The doctors of the association never administer drugs lead to death and they just prepare for a drip infusion with a strong poison and a patient removes a stopper of drip infusion by him/herself to die.)

But it was a light of hope for her. Then, she got contact with the journalist to tell that she was seriously thinking about doing euthanasia in Switzerland, and the documentary program and the book writing had started from the moment. (For your reference, the Japanese journalist never pushed her decision to go to Switzerland for euthanasia, and it was completely decided by herself and her sisters accepted her own will. On the other hand, the documentary also introduced the other case of the patient who suffered from the same illness and decided to keep living even with a respirator. So, the program provided both cases in a neutral position.)

What is the situation in Japan around euthanasia?

As I told you, euthanasia has not been legalized in Japan yet. Generally speaking, a definition of euthanasia is vague, but it is said that we can classify into 2 categories; the one is a positive euthanasia and the other is a passive euthanasia. The former means that patients under incurable illness make a decision to terminate their life with their own will and will die by doctor’s supporting to administer drugs lead to death. The latter means that patients under incurable illness stop prolong life longer by a life-expansion device, and doctors / their family wait for ending their life naturally by giving palliative care. And it is sometimes called “Death with Dignity”.

In fact, it seems that the concept of passive euthanasia has already accepted by people and actually done at hospitals by doctors in Japan based on prior conformation of intent by patients and their families. However, if the positive euthanasia is executed even with the patient’s wish, the doctors and persons concerned will be charged with murder in this country. Anyway, we have currently no choices in Japan in case we want to terminate our life earlier even under situations like her. There is no right to die legally, so that above Japanese lady had to decide to go to Switzerland to receive the right to terminate her life.

According to some survey in Japan about euthanasia in the past, 70% of respondents agreed with euthanasia if they suffer from an incurable illness with great pain, and they prefer to be legalized euthanasia. If so, why the discussion about the legalization of euthanasia has not being deepened in Japan?

I heard that there are several opinions to the question. For example, people would like to accept it for their own case, but they cannot accept it for their family members although they hope to do it with their own will. Besides, there is a fear that patients themselves tend to choose euthanasia due to avoid bothering their family and people around them, not for themselves. Furthermore, a peer pressure may increase in society that elder people with serious illness and health problems should choose euthanasia before bothering others once euthanasia is legalized in Japan.

I understand the possibility of these things happen in Japan. Because Japanese is an ethnic group of collectivity and not bothering other people and society is considered as one of the virtues in this country. We are always expected caring for others before thinking about ourselves first. But when we talk about the topic, it should be talked based on their desire, not for caring others. The most important thing is how patients want to live and to end their life as a human being. Euthanasia should be told as individual human rights. Of course, I am talking about the topic in the premise that we need to have constant discussion including various people and strict rules is need to define for legalization of euthanasia.

I cannot tell all of her story in the documentary program and the book here, but her decision was thought-provoking for me. She commented during the program that her wish is making deep discussions among people about the issue and being legalized euthanasia in the future in this country. If the euthanasia will be legalized in Japan, people don’t need to travel to Switzerland and can stay here without setting the schedule to do it earlier. It is quite sure that we have discussed how to prolong our life under serious illness, but we seldom talk about what the patients really want to do, whether he/she desire to live longer or not. I feel the timing to consider the issue in our society is coming.

Then, what do I think about it and how about you…?

At first, I have to say that it is completely my personal opinion, not the opinion which represent whole Japanese people, I have been agreed with the ides of euthanasia since a long time ago. Why I am so interested in euthanasia is because of my experience which I suffered from serious chronic skin disorder in my 20’s. Actually, I had suffered from persistent and strong itchiness, could not stop from scratching all time, had exudate　from various parts of my body, which led to terrible insomnia and it made me hell for several years.

So, I seriously thought about being temporary death state or ending my life at the time. Now I completely understand that my disorder didn’t meet any requirement of euthanasia and my situation was a trivial compared with the case of the Japanese lady and other incurable illness, however, I supposed that her fear was the similar type of thing that how longer I had to be alive under the situation without finding any clue to recover at that time. (More than 20 years has passed since then, and my current skin condition got much better although it got a long time to recover and sometimes got worse.)

If I were in the same situation as her, probably I hope to choose euthanasia before being worse enough that I cannot decide by myself. I am not willing to stay alive by spending lots of time and money in spite of doing nothing, and I cannot find out the purpose to live under such a situation. It is a too hard challenge for me that I can do nothing without other’s assists all time except laying on bed and watching the ceiling all time. I would like to have a right to make my own decision for my life ending.

The problem is that we have currently no choices in my country other than committing suicide even if we prefer not to live longer and want to terminate our life under such under the situation seems hopeless. Of course, I know that we need to have very deep discussions and arguments repeatedly among people who are agree / disagree with. But I hope someday in the bear future will come to legalize euthanasia in Japan even it is very difficult discussion.

However, I don’t mean that people who suffused from incurable illness should give up to live. The most important thing is how patients are concerned about their situation and own life. If you are eager to live longer by receiving support from people around you, of course, I hope that your family, friends and cares will support you with full effort by respecting your choice.

For example, one of my family members are currently face with terminal cancer. She has suffered from the illness for a long time and been in severe situation. However, she never gives up living and is challenging to take hard chemotherapy to be prolong her life right now. Her attitude toward life is completely opposite end of the idea of euthanasia. I sometimes feel sorrow by thinking her hardship and I have no confidence whether I can stand the situation if I were her. This is her own decision and all I can do is just supporting and following according to own desire as long as she has a zest of living. In the meantime, I am also ready to respect her decision in case she is willing to stop battling with the illness. All I hope for her is that she can complete the life she wants.

Sorry for writing such a long essay and thank you for your patience to read all of them. What do you think and what is your opinion about the way to end your life when you are under the situation like the Japanese lady? And how about the issue around euthanasia in your country? I am very curious about it….