What "Euthanasia and Dignified Death" Taught Me About Living Fully

Masayasu Hosaka's Euthanasia and Dignified Death: Life and Death in Medicine (Kodansha Gendai Shinsho) is the book behind this personal record of what I've actually started doing at 66. I'll admit I picked it up with some hesitation. I entered a national university's medical school and left it some years later for personal reasons — so "life and death in medicine" felt like a look at the road not taken. By the end, though, I realised this wasn't really a book about how to die. It was a book asking, quietly, how to live today.

This illustration was created to capture a moment of quietly, unhurriedly contemplating life and death.

Practice 1: Learning to explain the difference between "euthanasia" and "dignified death" in my own words

I was a little embarrassed to realise I'd been treating these two terms as roughly interchangeable for years. The book carefully separates them: actively hastening death is a fundamentally different question from withholding excessive life-prolonging treatment and letting a natural course take place.

During my five years in medical school I learned the basics of Western medicine, but I never really worked through this distinction as a clinical matter. Now, whenever the topic comes up in the news, I pause and ask myself which of the two is actually being discussed. Handling words precisely feels like unglamorous but essential preparation for talking with family and doctors clearly, if the time ever comes.

Practice 2: Thinking about the cycle of life through the greenhouse and raised beds

One thing the author returns to repeatedly is the unanswerable question of what life actually is. Reading that, I kept thinking of the garden I tend every day.

At our house in the UK, I spend time gardening in the back garden. Seeds sown, shoots emerging, fruit forming, plants dying back, becoming compost, feeding next year's soil — watching this cycle repeat every year, I find I understand "where life comes from and where it goes" in my body before I ever work it out in my head.

This illustration was created to evoke the cycle of budding, bearing fruit, and returning to soil, through the crops and roses grown in the greenhouse and raised beds.

Asparagus takes several years from planting to harvest, and roses only bloom beautifully once you've pruned them properly, year after year. Extending healthy life expectancy feels similar — not something that shows results in a single year, but something cultivated over many years, the way I tend the garden.

Practice 3: Making "today" a little lighter

The book includes not just statistics and institutional debate, but records of the small daily choices made by people actually living through terminal illness. Reading those, I've started deliberately treating "today" a little more lightly.

Lately I forget things more often, and names of people or things don't come to me as quickly. I used to find that irritating; now I let it go with something closer to "if I can't recall it today, I'll remember it tomorrow." A few minutes stroking Meg (our cat) while looking out at the garden, a few minutes opening the greenhouse door to check on the vegetables — deliberately building in one such pause each day has become my practice of living in the present.

Practice 4: Talking with family about "just in case"

A theme that runs through the book is the importance of advance directives — putting your own wishes into words while you're still well. I read this less as a conversation about death itself, and more as a very practical matter: telling the people who matter to you what you'd want, before you need to.

"How much treatment would I want, if it came to that" is something that needs a conversation with family, not a spreadsheet. My wife and I now touch on this occasionally, keeping it light rather than heavy, almost as an aside in ordinary conversation. Reducing financial worry and making your medical wishes known both turn the vague fear of "I don't want to burden my family" into something concrete you've actually prepared for.

Practice 5: Keeping a comfortable distance in relationships, without forcing it

This is a step away from the book's central theme, but reading the author's reflections on how one takes ownership of one's own life made me think about relationships after retirement. During my working years there were people I had to see regardless of how I felt about it. Retired now, most of that obligation has fallen away.

Even so, there are still old acquaintances who leave me a little drained after seeing them. I now let myself decide how often, and for how long, without forcing more contact than I want. Alongside the loneliness that can come with a shrinking connection to society after retirement, I've come to think that not straining to maintain every relationship is also part of tidying up one's relationships at 66.

Practice 6: Making Eastern medicine and complementary therapies companions for ageing

This is a book written within a Western medical framework, but reading it, I found myself thinking about the acupuncture, Kampo herbal medicine, and homeopathy I've studied for years. As I understand it, these aren't medicine aimed at postponing death — they're medicine aimed at keeping today's condition as comfortable as possible.

Easing cold sensitivity with sen-nen kyu moxibustion, loosening stiffness with light therapy, choosing Kampo formulas suited to one's constitution — if Western medicine handles "treatment," these practices handle "keeping day-to-day condition in balance." Reading this book, on such a weighty theme as euthanasia and dignified death, reminded me that not neglecting small daily discomforts, and gently tending to them through Eastern medicine, is itself a way of living well today.

On the "goodness" of living

I finished this book without a clear answer to "what is goodness" or "what is happiness." But one thing became clear to me: thinking about how one meets death turns out to be the same thing as thinking about how to live today.

The book I mentioned here:

Masayasu Hosaka, Euthanasia and Dignified Death: Life and Death in Medicine (Kodansha Gendai Shinsho)

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Masayasu Hosaka, the man and his era

This illustration was created to evoke the atmosphere of the Showa era that Masayasu Hosaka lived through.

Masayasu Hosaka was born in 1939 in Hokkaido — as it happens, the same prefecture I was born in, which gave me an extra sense of connection while reading. He was a child during the war and its aftermath, living through defeat and postwar reconstruction, and that early experience shaped his lifelong work as a historian of the Showa era — above all his enormous body of interviews with war survivors and his research into the Pacific War.

Having spent a career as a chronicler of an age lived alongside mass death, his approach to the themes of euthanasia and dignified death in this book feels quietly informed by that history. Rather than arguing loudly for a single position, he builds his case from accumulated facts and testimony, leaving judgement to the reader — the same stance, I think, that comes from decades spent listening carefully to individual war survivors. His refusal to let fading memory be an excuse to stop recording, and his insistence on writing things down for the next generation instead, quietly encouraged me, at 66 and forgetting more names than I used to, about the value of writing things down myself.