Introduction: The Distance from Euthanasia
Entering, thinking about death, facing death

Chapter 1: Genetic Testing for Cerebellar Ataxia
Chapter 2: The Poor Girl's Tears
Chapter 3: Loving Each Other, Traveling Hand in Hand
Chapter 4: Rehabilitation and Passionate Living
Chapter 5: Father's Eternal Rest, Mother's Freedom
Chapter 6: Days with a Caregiver
Chapter 7: Euthanasia of Your Own Choice
Chapter 8: Letting go is the greatest state of love.
Chapter 9: The Way of Fasting
Chapter 10: Funeral before death
Chapter 11 Three Funerals, Three Kinds of Love
Chapter 12: An Unexpected Journey Through Euthanasia
Chapter 13: Legislative History of the Right to Euthanasia
Chapter 14 Self-help Where Euthanasia Is Not Permitted

Postscript 1: Mother's Honorable Death, Reconciliation with Father
Review 2: The Most Valuable Lesson: My Mother's Transcendence in the Face of Death
Review 3: The Dilemma of Life and Death
Translator's Note

Mother's death through hunger strike
The last lesson I left for my children

The author's mother, already in her middle age, discovered that she had a genetic disease called cerebellar ataxia, which ran in her family (her maternal uncle and cousins ​​had died miserably because of it).
Since it was a disease that had a 1 in 2 chance of developing if one parent had it, the mother insisted that the three siblings also be tested, and the author and his younger sister were confirmed to not have inherited it through testing.
However, my younger brother insisted on not getting tested because he had no children and the disease had no cure.
Having witnessed the unfortunate fate of her relatives who had this disease, the mother entrusts her eldest daughter, a doctor, with her final days.
Thanks to her regular yoga practice, the onset of the disease was delayed and she was healthy enough not to need additional rehabilitation exercises. However, as the disease progressed, she lost her will to live and wanted to be free from the pain as soon as possible.


But since the passage of a euthanasia bill in Taiwan seemed a long way off, the mother and daughter discussed the idea of ​​a dignified death through voluntary fasting, and the mother resolved to begin the process after her birthday the following year. The mother stopped fasting and gradually reduced her food intake.
The fasting method of dying with dignity by abstaining from grains was specifically proposed by Dr. Jinichi Nakamura as follows: 'abstaining from 5 grains for 7 days, abstaining from 10 grains for 7 days, abstaining from eating wild plants and fruits for 7 days, and abstaining from water for 7 days.'
They did not eat fish or meat, but ate porridge, boiled vegetables, and fruit as their staple foods. They also consumed oil and lotus root to reduce hunger and prevent bloating.
After 11 days of fasting, I stopped eating all solid foods, and two days later I stopped eating lotus root juice.
From the 18th day onwards, my mother's sleep time became longer, and on the 21st day, she passed away with a peaceful expression on her face.

My mother showed unwavering, strong will until the very end, and my family respected my mother's decision because they had always talked about death naturally and shared their thoughts with each other.
However, this does not mean that everything went smoothly.
The mother complained of physical pain during the fast, and the family members who watched her had to hold their chests.
Nevertheless, for the three siblings, this entire process was also a lesson given by their mother.
Half a century ago, it was common for people to die at home, but now about 80 percent of people die in hospitals or nursing homes.
Jinichi Nakamura recommended that people die naturally at home instead of being rushed to the hospital right before their death, receiving meaningless treatment, and even being treated by a "medical professional" who performs CPR, and he said that this would be the last legacy he could leave to the next generation.
The Dalai Lama views death positively, saying:
“Just as old, worn-out, and torn clothes need to be replaced, the same thing applies to the body when it becomes damaged.
Death is that simple, it is not a mysterious or dark thing.”

Also, in hospitals, it is often difficult to spend enough time with family members to say goodbye, but when a person dies naturally at home, there is ample time to sit down with family members and share their feelings.
In fact, the author's family held a funeral for his mother and reminisced about her life together, expressing their respect and gratitude for how wonderful a person she was and how hard she lived.
Through this, both the person leaving and the person being left behind can feel the deep affection between family members without regret.

How should the 'right to self-determination' be respected?

In the 1980s, when the author was working at National Taiwan University Hospital, the mother of Wang Xiaomin, who was in a vegetative state, raised the need for euthanasia laws, saying that she did not want her daughter to suffer any longer after caring for her daughter for 20 years without any improvement, and this sparked a social discussion.
In Taiwan, hospice palliative care was introduced, and the 'Palliative Care Ordinance' and the 'Patient Autonomy Act' were implemented.
This allows patients to express their wishes in advance so that they can escape the pain they are currently experiencing or so that they can do so in the future.
However, there are still many areas that need improvement in terms of the scope and timing of application.
Meanwhile, the medical and religious communities still voice opposition to the euthanasia law.
The first reason is that ending a patient's life is like eliminating the chance for them to get better.
In this regard, the author points out that since doctors are not gods, there are bound to be limitations in medical care.
Mr. Pudarun, who chose euthanasia in Switzerland, suffered from severe side effects due to pain that could not be relieved even with palliative care and a morphine allergy.


Second, there is the opinion that euthanasia violates medical ethics.
The author argues that even if euthanasia legislation is passed, individual doctors have the right to choose not to participate, and that the medical community has no right to urge all doctors not to participate.
Going forward, we must move toward greater respect for patients' "right to self-determination of death," and we must improve our thinking to consider helping patients achieve a peaceful death as part of medical care.
Additionally, there are concerns about the so-called 'landslide effect'.
If the euthanasia law is passed, it means that the socially vulnerable will be encouraged to choose death or that the person concerned will be pressured to make such a choice. However, if we refer to statistics from the United States and the Netherlands, we can see that concerns and reality are different.
Discussions about 'well-dying', or euthanasia, should no longer abstractly glorify death or reduce it to someone else's case.
This book primarily deals with the current state of Taiwanese society and its cases, but it also presents sharp topics of debate in Korean society, where issues such as an aging society, poverty among the elderly, and patients' right to self-determination are becoming increasingly important.