[Accumulation of health problems as grounds for euthanasia].

BACKGROUND: The accumulation of health problems as grounds for euthanasia often poses a challenge for physicians. The distinction between the accumulation of health problems and a 'completed life' is sometimes hard to make. Suffering is subjective and the question is if and to what extent pronounced anticipatory suffering and detachment should be considered in the request for euthanasia.

CASE: A very old lady, who sets great store by propriety, requests euthanasia because she feels she will no longer be able to live an independent life. Her symptoms are related to a number of chronic degenerative disorders which have as yet not affected her functioning. Objectively, her case appears to be insufficiently severe. The physicians involved in her case differ in opinion until a new diagnosis resolves outstanding dilemmas.

CONCLUSION: Chronic symptoms and loss of function, a diminishing capacity, limited life perspective and the inevitability of and fear for pending care dependency can make life intolerable for the elderly individual. Careful consideration of the suffering and an empathetic approach are key to responding appropriately to a request for euthanasia.