Health experts call alleged assisted death of woman with ALS “fundamentally different” from previous cases due to payment issue

By Barrier Free Japan, Kyodo

July 30 2020

OSAKA – Health experts are calling the case of two doctors arrested last week on suspicion of assisting in the death of a 51-year-old woman with ALS “fundamentally different” from past euthanasia cases that led to other doctors’ convictions for murder in Japan, because she allegedly asked them to kill her for money on Twitter.

The two suspects, one who operates a clinic in Natori, Miyagi Prefecture, and another doctor in Tokyo, allegedly administered a lethal dose of barbiturates to Yuri Hayashi at her home in the western Japan city of Kyoto on Nov. 30 with her consent, investigative sources said.

Short-acting barbiturates, such as pentobarbital, taken in large dosages cause death by respiratory arrest and are known to be used by groups that assist with suicides in Europe and the United States.

Hayashi’s disease, amyotrophic lateral sclerosis, also known as Lou Gehrig’s disease, causes gradual paralysis with no fundamental treatments established.

It was Hayashi who offered 1.3 million yen ($12,400) for the job, nearly the same amount charged by a Swiss group for assisting suicides.

On the day of the incident, the suspects, using false names, visited Hayashi’s apartment in Kyoto’s Nakagyo Ward. They left about five to 10 minutes later, and a caretaker, who had left the room while the doctors were with the woman, found Hayashi unconscious soon after. She was later pronounced dead at a hospital.

A Kyoto prefectural police official, who summarized the case to the media last Thursday night, said questions were raised about “whether this can even be considered a case of euthanasia” because of the transfer of money involved. The investigative sources also said one of the two arrested is suspected of having obtained his medical license illegally.

Experts have also expressed outrage over what appeared to be a contempt for the suffering woman’s life because of the intention of getting money, while many Twitter users have said they still empathize with Hayashi’s wish to die.

Kaoruko Aita, a specially appointed professor of clinical ethics at the University of Tokyo’s graduate school, said, “If doctors who weren’t her attending physician took the money and administered a drug, this case is totally different from previous cases involving doctors or cases of non-indictments.”

“It is fundamentally different from the arguments built up by the state and those involved in cases concerning end-of-life medical treatment,” she said.

Aita said if the doctors did in fact administer a heavy dose of sedatives to end Hayashi’s life, she worries such acts “might cause misunderstanding and confusion among workers trying to remove pain from patients in palliative care through appropriate use of sedatives.”

In Japan, patients who have no hope of recovery or are terminally ill, may hope for what is termed “death with dignity,” which differs from euthanasia, as the patient requests a natural death by refusing to artificially prolong life with medical treatments and devices.