Pentobarbital (N) is NOT as good as it seems. Not even close.

[I_go_in]

That's cool bro. If you drink it and don't throw it up you'll 100% die. It's literally not possible to live if you somehow get it into your body and take the right amount. Somebody paying you to post here?

 

[ThatStateOfMind]

I could never inject myself, I am glad I found a way to get SN. The payment process however is just as hard as finding the source to begin with.

Can agree, I haven't bought any but have gotten close. The payment methods stopped me in my tracks as I didn't expect PayPal to have been removed as an option, but it was removed, and there's new methods.

 

[Sunset Limited]

I agree with OP that oral administration is unnecessary to euthanasia. Bitter taste, risk of vomiting, prolonged time to death, premedication. I personally prefer IV thiopental. Maybe 2-4 mg midazolam as an anxiolytic first, then standard thiopental anesthesia induction dose (High concentration vascular irritation), 5 grams thiopental a minute later.

Still I have no problem in saying that oral N is the golden standard to someone who cannot access euthanasia. İt is just drink and go. Vomiting is rare with GABA-A receptor agonists. You probably won't vomit even if you don't use meto. Vomiting usually occurs after the medical procedure. Maybe the inert gas method can be better, but if you live alone and will be doing it at home. Still, I personally would rather drink something than deal with a cylinder, tubes, flow regulator, mask. You can carry N everywhere also.

 

[Gone.]

So, you've not tasted it yourself then? Ok.


You'll most likely be asleep (anaesthetised) before being able to self administer the full dose.


No, what it says in that document is 3-10% may not die within 2 hours, indicating the studies differ - there is no defined failure rate. It does not state anywhere that the failure rate is rather high. You would also be unconscious, and will die within 24 hours; but the clinics use an IV option to reduce that time.

I appreciate you've got your own views on the peacefulness or reliability of oral N, but that doesn't make your views the correct one. By all means share your research for others to read and feed into their own decisions, but to just state it's not a good method is incorrect, imo.

Even if I have tasted it myself, it would not be evidence-based as a sample size of 1 is nothing.

It takes five minutes to lose consciousness, and that is more than enough time to push. Worst case you can also do a pressure infusion. I advocate for evidence-based practise and that's it.

Bitterness in the mouth is hardly that bad. N was used in medical euthansia by several doctors in switzerland already. Please be more conscientious with your sources and things you say. Fairly low quality post, and pretty useless.

Any sources in re: bitterness in mouth that shows otherwise? Just because it's used doesn't mean it's ideal. Hence why internationally, IV euthanasia is the current evidence-based practise.

We can't really get any where if we are basing our argument off of "it looks peaceful but what if it's not". I mean one could argue "they look dead, but what if they are not?". If it looks peaceful and fast it's because it is. You would definitely know if it wasn't peaceful. One would definitely know how you are feeling while getting lumbar puncture w/o an anesthetic. Although it isn't an intolerable pain, patients usually can't sit still both from the anticipation of what's coming plus whatever pain they feel. Which is when physicians avoid doing it w/o an anesthetic. No one would wanna be near your spine with that giant needle while you are writhing. There is no such a thing as "it's so much more painful than it looks". One could maybe say "it's not as bad/painful as it looks".

And that is why you make sure the patient is dead before declaring death.

I agree with OP that oral administration is unnecessary to euthanasia. Bitter taste, risk of vomiting, prolonged time to death, premedication. I personally prefer IV thiopental. Maybe 2-4 mg midazolam as an anxiolytic first, then standard thiopental anesthesia induction dose (High concentration vascular irritation), 5 grams thiopental a minute later.

Still I have no problem in saying that oral N is the golden standard to someone who cannot access euthanasia. İt is just drink and go. Vomiting is rare with GABA-A receptor agonists. You probably won't vomit even if you don't use meto. Vomiting usually occurs after the medical procedure. Maybe the inert gas method can be better, but if you live alone and will be doing it at home. Still, I personally would rather drink something than deal with a cylinder, tubes, flow regulator, mask. You can carry N everywhere also.

I agree that oral pentobarbital is the ideal oral agent for euthanasia. Also, can you cite your claim on GABA-A agonists and vomiting? I've never heard about that and I'd love to read :)

 

[davidtorez]

ChatGPT 4o mini

Log in
You said:
Is Vomiting is rare with GABA-A receptor agonists?
ChatGPT said:
ChatGPT
Vomiting is not typically common with GABA-A receptor agonists, but it can occur, especially at higher doses or in sensitive individuals. Do you have a specific medication in mind, or are you referring to a general class of drugs?



You said:
Barbiturates especially pentobarbital
ChatGPT said:
ChatGPT
Vomiting can occur with barbiturates, including pentobarbital, but it is not typically considered a primary side effect. Barbiturates, which act as GABA-A receptor agonists, have a range of potential side effects, including sedation, respiratory depression, hypotension, and in some cases, gastrointestinal issues like nausea and vomiting.

Vomiting may be more likely if the drug is taken in high doses or if there is an overdose situation. Additionally, pentobarbital can depress the central nervous system to the point of affecting the gastrointestinal system.

If vomiting occurs with pentobarbital, it could indicate an adverse reaction, overdose, or sensitivity to the drug, and medical attention would be warranted. It's always important to use such medications under strict medical supervision, given their narrow therapeutic index.
This is why it is VERY important to take something like metoclopramide before drinking oral N especially the injectable veterinary drug .

 

[Gone.]

ChatGPT 4o mini

Log in
You said:
Is Vomiting is rare with GABA-A receptor agonists?
ChatGPT said:
ChatGPT
Vomiting is not typically common with GABA-A receptor agonists, but it can occur, especially at higher doses or in sensitive individuals. Do you have a specific medication in mind, or are you referring to a general class of drugs?



You said:
Barbiturates especially pentobarbital
ChatGPT said:
ChatGPT
Vomiting can occur with barbiturates, including pentobarbital, but it is not typically considered a primary side effect. Barbiturates, which act as GABA-A receptor agonists, have a range of potential side effects, including sedation, respiratory depression, hypotension, and in some cases, gastrointestinal issues like nausea and vomiting.

Vomiting may be more likely if the drug is taken in high doses or if there is an overdose situation. Additionally, pentobarbital can depress the central nervous system to the point of affecting the gastrointestinal system.

If vomiting occurs with pentobarbital, it could indicate an adverse reaction, overdose, or sensitivity to the drug, and medical attention would be warranted. It's always important to use such medications under strict medical supervision, given their narrow therapeutic index.
This is why it is VERY important to take something like metoclopramide before drinking oral N especially the injectable veterinary drug .

Agreed - Hence the current protocol calling for 8mg ondansetron and meto~

 

[Tesha]

It takes five minutes to lose consciousness, and that is more than enough time to push. Worst case you can also do a pressure infusion. I advocate for evidence-based practise and that's it.

May I suggest you do some research on the speed of action of IV pentobarbital sodium (N)

Spoiler: Spoiler

it's near instant

You need to remember you'll be trying to administer fatal, not dosed anaesthetic quantities.

 

[Gone.]

May I suggest you do some research on the speed of action of IV pentobarbital sodium (N)

Spoiler: Spoiler

it's near instant

You need to remember you'll be trying to administer fatal, not dosed anaesthetic quantities.

So maybe do a drip or something. Or some sort of mechanism using springs or elastics to push the drug.

 

[davidtorez]

Agreed - Hence the current protocol calling for 8mg ondansetron and meto~

Is ondansetron fairly easy to acquire?

 

[antony]

I've been a lurker here for years and would choose N (Pentobarbital) over any other method. Dying isn't a very pretty thing anyway.

Now regarding the taste, it's horrible, I've been using low doses for insomnia, lots of juice in the mix!

 

[lifeisbutadream]

N from D (years ago). Sold as 6.5G, but tested at 6.7G. I've orally tried up to 5ml in one go, but I had a benzo tolerance at that time.

How does benzo tolerance effect N? I have read contradictory info - that it enhances the effectiveness of the N, and on the other hand that it diminishes the effectiveness of the N.

I do not understand which parts of the post or the articles make pentobarbital be "not as good as it seems"?

Yes, people need roughly 15 grams to succeed, and that means they require a few bottles of the veterinary version, but that means the only part of the article which possibly raises any kind of an issue is the bitter aftertaste. There is literally nothing else about pentobarbital that matters in any way. And I would say some bitterness is not really that relevant.

Besides, experience tells us something else, otherwise they would not be using the substance in Switzerland.

I believe that no one is known to have survived even 6 grams of N. It is just that a larger amount works more quickly avoiding a possible coma stage that might last hours.

Bitterness in the mouth is hardly that bad. N was used in medical euthansia by several doctors in switzerland already. Please be more conscientious with your sources and things you say. Fairly low quality post, and pretty useless.

I also thought it - powdered n - was not so bad. It tasted something like ground up aspirin, if you chew an aspirin. The odor was astringent though. Hold your nose i think. Other people may be more sensitive to bitter substances. Coat your mouth with honey first.

That's cool bro. If you drink it and don't throw it up you'll 100% die. It's literally not possible to live if you somehow get it into your body and take the right amount. Somebody paying you to post here?

I'm not sure about this but i think i read that even if you do throw up after ingesting n you will still most likely die. Is that correct?

Is ondansetron fairly easy to acquire?

Yes, but i did read that it was not effective for N. Has that changed? Is it OK alone or must it it be taken with met., which is not that easy to acquire and may occasionally have very bad side effects.

 

[Willy Wonka]

Oh dear, I flushed my N down the toilet right away! Thanks for the warning!

same here, thank god - I was really that close ...

LOL

haha

 

[Talvikki]

Existing research indicates an average of five minutes between consumption and LOC, so during that five minutes, you'll be there feeling the full force of the bitterness. (Sinmyee, S., Pandit, V. J., Pascual, J. M., Dahan, A., Heidegger, T., Kreienbühl, G., Lubarsky, D. A., & Pandit, J. J. (2019). Legal and ethical implications of defining an optimum means of achieving unconsciousness in assisted dying. Anaesthesia, 74(5), 630–637. https://doi.org/10.1111/anae.14532)

It takes time, a long time, for your GI tract to absorb the medication, which is why other routes of administration exists. If the GI tract can absorb drugs instantly, other routes of administration would never have to be invented.

The authors of the article refer to reports from the 1990s regarding assisted suicide and euthanasia in the Netherlands. These reports are both incomplete and outdated.

In the first half of 2000, Groenewoud et al. published an analysis of clinical issues encountered by Dutch physicians who performed euthanasia on 535 patients and assisted suicide on 114 patients during the periods 1990–1991 and 1995–1996. However, the specific drugs used in these cases were not mentioned.

Unfortunately, the study lacks a clear explanation of the relationship between the observed time intervals, the different euthanasia drugs used, and their routes of administration. This omission leaves readers entirely in the dark about the reliability of the various drugs.

It would have been practically significant if the publication had addressed this issue. As it stands, the information is not only outdated but also incomplete.

Hi, I wanted to address all those who still believe that pentobarbital (N) is the gold standard.

Intramuscular, subcutaneous or any injection route other than IV, IC, or IP is NOT acceptable, even in veterinary practise. Oral pentobarbital is not recommended, and is even illegal in many jurisdictions for veterinary euthanasia.

The Humane Society of the United States' publication. The Society recommends the use of pentobarbital for the purpose of veterinary euthanasia, administered via intravenous (39 mg/lb), intraperitoneal (117 mg/lb), or intracardiac (39mg/lb) route. The Society explicitly states that no other injection routes are permissible.

Intracardiac injection is extremely painful. The Society only recommends the use of intracardiac injection when the patient is fully unconcious, and in humans, the use of this route is extremely rare outside of emergencies (if a patient is actively coding) and is guided to avoid injecting into the lung accidentally.

The oral route of pentobarbital is generally not advisable in veterinary practise as pentobarbital is extremely bitter and requires 3x the IV dose. In humans, a minimum of nine grams is required to achieve death. However, new evidence indicates that 15 grams is required to achieve death consistently in humans. Human administration is always preceeded by an administration of antienemics. Euthasol, the formulation commonly found in American veterinary practise, contains 390mg/ml. Using the latest guidance, this means the patient will be required to orally consume 38.46ml of Euthasol in order to die. And recall that that pentobarbital is extremely bitter and unpleasant to consume, and results in nausea hence the administration of antienemics. Oral pentobarbital also takes quite a while to kill, with the average length in bearded dragons to be 300 minutes.

Existing research indicates an average of five minutes between consumption and LOC, so during that five minutes, you'll be there feeling the full force of the bitterness before you finally pass out. 10% of patients vomit after consuming pentobarbital, antienemic notwithstanding. 9% have difficulty swallowing the dose, and emerging out of coma in 2 percent of cases.

Therefore, it is of my opinion that pentobarbital is not optimal for the use in human euthanasia, and that other avenues must be explored.

References

EUTHASOL®(pentobarbital sodium and phenytoin sodium)Euthanasia Solution

Assistierter Suizid in der Schweiz - Sterben auf Wunsch

In der Schweiz nehmen sich mehr Menschen mit Begleitung von Suizidhelfern das Leben als ohne Begleitung. Manche Experten sagen: So könnte es auch bei uns in zehn Jahren aussehen. Ist unser Nachbarland ein Vorbild für Deutschland oder muss uns die Entwicklung zu denken geben?

www.deutschlandfunk.de

https://doi.org/10.2146/ajhp100333

https://humanepro.org/sites/default...g/view/journals/ajvr/85/6/ajvr.24.02.0026.xml

Transmucosal administration of pentobarbital and phenytoin solution induces euthanasia in bearded dragons (Pogona vitticeps)

Abstract OBJECTIVE To assess the efficacy of transmucosal euthanasia solution to induce euthanasia. ANIMALS 6 bearded dragons (Pogona vitticeps). METHODS An initial dose of euthanasia solution containing pentobarbital and phenytoin sodium was administered transmucosally in conscious lizards (100...

doi.org

https://doi.org/10.1111/anae.14532

N (pentobarbital) is as good as it seems

There are no complications when taking the N (pentobarbital) drink.

The N (pentobarbital) drink is equally reliable as dying after a lethal injection by a doctor.

 

[hereornot]

I agree that IV diluted in saline solution would be quite easy, but it requires hospital equipment and knowledge.

I have read about the oral use of N in Switzerland, where they said the dose was 100ml based on Pentobarbital (Neambutal) but with a sweet flavor.

I believe that not much more than 20ml of Pentobarbital is necessary, so a sweet diluent should be used that does not interfere with the medication. So the 100ml described makes sense.

If anyone has knowledge about this, it would be great to share. Syrups for children, for example, are sweet so that they do not taste bitter. I wonder if anyone can research what could be used.

It would help both N and SN.

 

[Gone.]

The authors of the article refer to reports from the 1990s regarding assisted suicide and euthanasia in the Netherlands. These reports are both incomplete and outdated.

In the first half of 2000, Groenewoud et al. published an analysis of clinical issues encountered by Dutch physicians who performed euthanasia on 535 patients and assisted suicide on 114 patients during the periods 1990–1991 and 1995–1996. However, the specific drugs used in these cases were not mentioned.

Unfortunately, the study lacks a clear explanation of the relationship between the observed time intervals, the different euthanasia drugs used, and their routes of administration. This omission leaves readers entirely in the dark about the reliability of the various drugs.

It would have been practically significant if the publication had addressed this issue. As it stands, the information is not only outdated but also incomplete.


N (pentobarbital) is as good as it seems

There are no complications when taking the N (pentobarbital) drink.

The N (pentobarbital) drink is equally reliable as dying after a lethal injection by a doctor.

Oral pentobarbital is not as reliable. Please see the BC guideline, where it states that IV is more reliable than oral. If you would like to make such claims, I would love to see the evidence that backs it up, so please send it over~

 

[OnMyLast Legs]

they won't sell us N syringes

This means: consumers can't buy syringes big enough. Right?

 

[Gone.]

This means: consumers can't buy syringes big enough. Right?

No...? You can get needles and syringes of any size OTC...

 

[OnMyLast Legs]

No...? You can get needles and syringes of any size OTC...

Hmm. I guess this person just means you can't buy N.

 

[nogods4me]

N is the gold standard but N + F would be the platinum.

 

[Gone.]

N is the gold standard but N + F would be the platinum.

Right, but I am here to challenge that standard as current literature seem to contradict that it is the gold standard. Fentanyl is not necessary in combination with pentobarbital as either one would kill you (although fentanyl is, in my opinion, more optimised)

 

[Talvikki]

Oral pentobarbital is not as reliable. Please see the BC guideline, where it states that IV is more reliable than oral. If you would like to make such claims, I would love to see the evidence that backs it up, so please send it over~

No problem,

Dying after a lethal injection by a doctor is not preferred by doctors and pharmacists over letting the patient drink the N (pentobarbital) themselves. This is stated in the revised KNMG/KNMP Guideline Implementation of Euthanasia and Assisted Suicide in the Netherlands. Both methods are equally reliable, say both organizations.

Anyone requesting euthanasia in the Netherlands has a choice of two methods for its implementation.

1. Euthanasia: The physician administers the euthanasia drug intravenously

2. Assisted suicide: drinking the euthanasia drug (pentobarbital) themselves

There is no longer a preference for euthanasia over assisted suicide. Both methods are equally reliable.

The guideline describes the professional standard and is based on the latest scientific and professional insights from various medical and pharmaceutical professional groups.



The Royal Dutch Pharmacists Association (Koninklijke Nederlandse Maatschappij ter bevordering der Pharmacie, KNMP) is the umbrella organisation for both professional pharmacists and the pharmacy in general.





The Royal Dutch Medical Association (RDMA; in Dutch Koninklijke Nederlandsche Maatschappij tot bevordering der Geneeskunst or KNMG)




---
---
---


The N drink is now a reliable alternative to injection in euthanasia

Professor of applied psychology Pieter Jan Stallen and general practitioner Michiel Marlet investigated over 200 examples of assisted suicide with the N (pentobarbital) drink. This shows that there are no complications with this method.

This is stated by the two doctors in the Dutch Journal of Medicine.









---
---
---


In addition to the guidelines, several doctors share their personal experiences and preferences regarding the oral and intravenous methods of euthanasia. The reactions of these doctors, which I have translated from Dutch to English, can be found in the journal for Dutch physicians."


I once assisted in suicide using this method, with the general practitioner in the background. My experience was that it went exceptionally smoothly. The patient explicitly wanted assistance in dying. This approach allowed him to be helped in a very respectful manner and in accordance with the law. Indeed, it involved less medicalization, but still with the care and diligence appropriate for such assistance. My experience makes me wonder why this method is not used more often—particularly for individuals seeking dignified assistance in dying.

---

I have extensive experience spanning approximately 35 years, and even with a dosage of 9 grams, I have never encountered any failures.

Pentobarbital offers several significant advantages:

It is the most suitable oral substance;

It is 100% reliable;

It causes no unpleasant side effects;

It allows the individual to emphasize their own decision to end their life;

The doctor takes a step back, allowing loved ones to take a more central role;

It significantly reduces the medicalization of the process.

While I also have experience with the intravenous method, it feels uncomfortable to actively end someone's life, especially while they are still connected to the needle.

---

After assisting in suicide three times, I have developed a personal preference for this method. It is profoundly dignified and allows for complete self-determination.

---

During my career, I consistently preferred the oral method. The fact that the patient takes the medication themselves, rather than passing away "on the needle," and, as my colleague describes, the proximity of loved ones, are all significant advantages in my view.

I recall a situation where the patient's wife struggled with his decision, but the eagerness with which he drank the solution helped her come to terms with his choice.

It has always surprised me how little attention is given to the oral method.

---

From multiple experiences, I can confirm that the oral method works exceptionally well and that concerns about failure are entirely unfounded. A dosage of 9 grams of barbiturate is an enormous overdose, ensuring that even in cases of choking, partial spitting out, or vomiting (none of which I have ever witnessed), the patient will still pass away.

---

On all three occasions that I have been involved, I was deeply impressed by the courage and determination shown by the patient. For patients who are capable, the oral method should be the first choice.

---

I have assisted with euthanasia using the oral method twice. In both cases, it went as described here, with the family members being very satisfied afterward.


---
---
---


NVVE: Updated information

Now that the current analysis confirms there are no complications associated with taking the N drink, the NVVE (The Dutch Association for a Voluntary End of Life) has updated its information regarding euthanasia options.

The focus should not be limited to the injection method alone. "We are currently grappling with an outdated guideline," the association stated.

The NVVE believes that the method involving the N drink should receive greater attention: "We have updated our information and educational materials to reflect this."




Source:

The Royal Dutch Pharmacists Association (Koninklijke Nederlandse Maatschappij ter bevordering der Pharmacie, KNMP) is the umbrella organisation for both professional pharmacists and the pharmacy in general.
https://www.knmp.nl/actueel/nieuws/...ing-euthanasie-en-hulp-bij-zelfdoding-herzien

The Royal Dutch Medical Association (RDMA; in Dutch Koninklijke Nederlandsche Maatschappij tot bevordering der Geneeskunst or KNMG)
https://www.knmg.nl/actueel/nieuws/...ing-euthanasie-en-hulp-bij-zelfdoding-herzien

NVVE (The Dutch Association for a Voluntary End of Life)
https://www.nvve.nl/actueel/nieuws/...nasie-en-hulp-bij-zelfdoding-even-betrouwbaar/

EénVandaag is a current affairs programme broadcast on the Dutch public television network NPO 1
https://eenvandaag.avrotros.nl/item...ef-bij-euthanasie-het-is-een-zachtere-methode/

NTvG; English: Dutch Journal of Medicine is the main medical journal in the Netherlands
https://www.ntvg.nl/artikelen/voorkeur-voor-hulp-bij-zelfdoding

Medisch Contact is the professional journal for Dutch doctors.
https://www.medischcontact.nl

Trouw (Dutch daily newspaper)
https://www.trouw.nl/nieuws/dodelij...voor-de-injectiespuit-bij-euthanasie~b3cd8289/

NPO Radio 1: Dutch public broadcasting organisation
https://www.nporadio1.nl/fragmenten...09-25-euthanasie-door-een-drankje-of-injectie

Expertisecentrum Euthanasie, is a Dutch euthanasia clinic
https://expertisecentrumeuthanasie.nl/

 

[Gone.]

No problem,

Dying after a lethal injection by a doctor is not preferred by doctors and pharmacists over letting the patient drink the N (pentobarbital) themselves. This is stated in the revised KNMG/KNMP Guideline Implementation of Euthanasia and Assisted Suicide in the Netherlands. Both methods are equally reliable, say both organizations.

Anyone requesting euthanasia in the Netherlands has a choice of two methods for its implementation.

1. Euthanasia: The physician administers the euthanasia drug intravenously

2. Assisted suicide: drinking the euthanasia drug (pentobarbital) themselves

There is no longer a preference for euthanasia over assisted suicide. Both methods are equally reliable.

The guideline describes the professional standard and is based on the latest scientific and professional insights from various medical and pharmaceutical professional groups.



The Royal Dutch Pharmacists Association (Koninklijke Nederlandse Maatschappij ter bevordering der Pharmacie, KNMP) is the umbrella organisation for both professional pharmacists and the pharmacy in general.

View attachment 155989



The Royal Dutch Medical Association (RDMA; in Dutch Koninklijke Nederlandsche Maatschappij tot bevordering der Geneeskunst or KNMG)

View attachment 155990


---
---
---


The N drink is now a reliable alternative to injection in euthanasia

Professor of applied psychology Pieter Jan Stallen and general practitioner Michiel Marlet investigated over 200 examples of assisted suicide with the N (pentobarbital) drink. This shows that there are no complications with this method.

This is stated by the two doctors in the Dutch Journal of Medicine.

View attachment 155991

View attachment 155992

View attachment 155993

View attachment 155994

---
---
---


In addition to the guidelines, several doctors share their personal experiences and preferences regarding the oral and intravenous methods of euthanasia. The reactions of these doctors, which I have translated from Dutch to English, can be found in the journal for Dutch physicians."


I once assisted in suicide using this method, with the general practitioner in the background. My experience was that it went exceptionally smoothly. The patient explicitly wanted assistance in dying. This approach allowed him to be helped in a very respectful manner and in accordance with the law. Indeed, it involved less medicalization, but still with the care and diligence appropriate for such assistance. My experience makes me wonder why this method is not used more often—particularly for individuals seeking dignified assistance in dying.

---

I have extensive experience spanning approximately 35 years, and even with a dosage of 9 grams, I have never encountered any failures.

Pentobarbital offers several significant advantages:

It is the most suitable oral substance;

It is 100% reliable;

It causes no unpleasant side effects;

It allows the individual to emphasize their own decision to end their life;

The doctor takes a step back, allowing loved ones to take a more central role;

It significantly reduces the medicalization of the process.

While I also have experience with the intravenous method, it feels uncomfortable to actively end someone's life, especially while they are still connected to the needle.

---

After assisting in suicide three times, I have developed a personal preference for this method. It is profoundly dignified and allows for complete self-determination.

---

During my career, I consistently preferred the oral method. The fact that the patient takes the medication themselves, rather than passing away "on the needle," and, as my colleague describes, the proximity of loved ones, are all significant advantages in my view.

I recall a situation where the patient's wife struggled with his decision, but the eagerness with which he drank the solution helped her come to terms with his choice.

It has always surprised me how little attention is given to the oral method.

---

From multiple experiences, I can confirm that the oral method works exceptionally well and that concerns about failure are entirely unfounded. A dosage of 9 grams of barbiturate is an enormous overdose, ensuring that even in cases of choking, partial spitting out, or vomiting (none of which I have ever witnessed), the patient will still pass away.

---

On all three occasions that I have been involved, I was deeply impressed by the courage and determination shown by the patient. For patients who are capable, the oral method should be the first choice.

---

I have assisted with euthanasia using the oral method twice. In both cases, it went as described here, with the family members being very satisfied afterward.


---
---
---


NVVE: Updated information

Now that the current analysis confirms there are no complications associated with taking the N drink, the NVVE (The Dutch Association for a Voluntary End of Life) has updated its information regarding euthanasia options.

The focus should not be limited to the injection method alone. "We are currently grappling with an outdated guideline," the association stated.

The NVVE believes that the method involving the N drink should receive greater attention: "We have updated our information and educational materials to reflect this."

View attachment 155998


Source:

The Royal Dutch Pharmacists Association (Koninklijke Nederlandse Maatschappij ter bevordering der Pharmacie, KNMP) is the umbrella organisation for both professional pharmacists and the pharmacy in general.
https://www.knmp.nl/actueel/nieuws/...ing-euthanasie-en-hulp-bij-zelfdoding-herzien

The Royal Dutch Medical Association (RDMA; in Dutch Koninklijke Nederlandsche Maatschappij tot bevordering der Geneeskunst or KNMG)
https://www.knmg.nl/actueel/nieuws/...ing-euthanasie-en-hulp-bij-zelfdoding-herzien

NVVE (The Dutch Association for a Voluntary End of Life)
https://www.nvve.nl/actueel/nieuws/...nasie-en-hulp-bij-zelfdoding-even-betrouwbaar/

EénVandaag is a current affairs programme broadcast on the Dutch public television network NPO 1
https://eenvandaag.avrotros.nl/item...ef-bij-euthanasie-het-is-een-zachtere-methode/

NTvG; English: Dutch Journal of Medicine is the main medical journal in the Netherlands
https://www.ntvg.nl/artikelen/voorkeur-voor-hulp-bij-zelfdoding

Medisch Contact is the professional journal for Dutch doctors.
https://www.medischcontact.nl

Trouw (Dutch daily newspaper)
https://www.trouw.nl/nieuws/dodelij...voor-de-injectiespuit-bij-euthanasie~b3cd8289/

NPO Radio 1: Dutch public broadcasting organisation
https://www.nporadio1.nl/fragmenten...09-25-euthanasie-door-een-drankje-of-injectie

Expertisecentrum Euthanasie, is a Dutch euthanasia clinic
https://expertisecentrumeuthanasie.nl/

Hi, looks like our guidelines differ. Can you send me the papers supporting yours? DOIs would be appreciated.

 

[whereas]

In Spain, euthanasia is carried out in two methods:
-Oral: antiemetic + benzo + 15g N
-IV: midazolam + lidocaine + propofol 1000mg + rocuronium/atracurium/cisatracurium

Since several countries are using N, I don't see why it's a problem

Also the patient chooses the method

 

[Gone.]

In Spain, euthanasia is carried out in two methods:
-Oral: antiemetic + benzo + 15g N
-IV: midazolam + lidocaine + propofol 1000mg + rocuronium/atracurium/cisatracurium

Since several countries are using N, I don't see why it's a problem

Also the patient chooses the method

Yes. I do agree that it is the (one of the) current best oral method. I just wanted to point out that even though it is currently the best, it is far from ideal, and that research has indicated that the IV regimen does not have the problems that orals have.

 

[wyo777]

Yes. I do agree that it is the (one of the) current best oral method. I just wanted to point out that even though it is currently the best, it is far from ideal, and that research has indicated that the IV regimen does not have the problems that orals have.

So basicly if You r finding N so bad, is there any other method that in your opinion is better?

 

[sevennn]

when it comes to the topic of assisted suicide/euthanasia - yes, i actually agree. but when it comes to this forum and what people on this forum have access to - no.

 

[leloyon]

I feel this is more of a flaw of people who gas it up as the greatest thing since sliced bread. I doubt we'll ever have a true perfect substance to CTB with, but I'd say N is the best that we currently have.

 

[Gone.]

So basicly if You r finding N so bad, is there any other method that in your opinion is better?

Yes - Propofol is an alternate method.

 

[wyo777]

Yes - Propofol is an alternate method.

It is anaesthetic, obviously overdose anaesthetic will kill you but there are reasons why anaesthetics are not used in assisted suicide or even in dead sentence. I was observing your activity and in my opinion u r trying to convince people that even this method is extremely dangerous. Im finding you as an big risk for this community. I understand that it is a risk with any method, believe me i understand, cause i was in peru, i purchased it and was too afraid to take it over there in case of landing up in a hospital over there. But....still...this is the best method in my opinion.

 

[Gone.]

It is anaesthetic, obviously overdose anaesthetic will kill you but there are reasons why anaesthetics are not used in assisted suicide or even in dead sentence. I was observing your activity and in my opinion u r trying to convince people that even this method is extremely dangerous. Im finding you as an big risk for this community. I understand that it is a risk with any method, believe me i understand, cause i was in peru, i purchased it and was too afraid to take it over there in case of landing up in a hospital over there. But....still...this is the best method in my opinion.

Except it is used in medically-assisted dying. It's the current method in lots of places, including in BC. It is used in human judicial executions too (Missouri in 2012) but AstraZeneca (the manufacturer) won't let them use it for that purpose.

I think you are a "big risk" for this community, since you are making unsubstantiated claims as facts, notwithstanding evidence to the contrary.

I feel this is more of a flaw of people who gas it up as the greatest thing since sliced bread. I doubt we'll ever have a true perfect substance to CTB with, but I'd say N is the best that we currently have.

I concur. Although pentobarbital is really nice, it's not perfect, and there are other drugs (in my opinion) that are superior, but those have their own downsides to it too. For example, with propofol, you need to put in an IV, which not everyone can do. I fully agree that pentobarbital is the best oral drug commercially available for now.

In Spain, euthanasia is carried out in two methods:
-Oral: antiemetic + benzo + 15g N
-IV: midazolam + lidocaine + propofol 1000mg + rocuronium/atracurium/cisatracurium

Since several countries are using N, I don't see why it's a problem

Also the patient chooses the method

Yup! I don't see a problem with it either. I agree that it is the optimal drug for oral administration that exists right now, and I wanted to share that there are really really significant downsides to oral administration. I'm not trying to say like "Pentobarbital is bad" or anything, since that's not true. It's just that a lot of people here make it sound like it's perfect, and I want to point out that it's far from perfect.

No problem,

Dying after a lethal injection by a doctor is not preferred by doctors and pharmacists over letting the patient drink the N (pentobarbital) themselves. This is stated in the revised KNMG/KNMP Guideline Implementation of Euthanasia and Assisted Suicide in the Netherlands. Both methods are equally reliable, say both organizations.

Anyone requesting euthanasia in the Netherlands has a choice of two methods for its implementation.

1. Euthanasia: The physician administers the euthanasia drug intravenously

2. Assisted suicide: drinking the euthanasia drug (pentobarbital) themselves

There is no longer a preference for euthanasia over assisted suicide. Both methods are equally reliable.

The guideline describes the professional standard and is based on the latest scientific and professional insights from various medical and pharmaceutical professional groups.



The Royal Dutch Pharmacists Association (Koninklijke Nederlandse Maatschappij ter bevordering der Pharmacie, KNMP) is the umbrella organisation for both professional pharmacists and the pharmacy in general.

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The Royal Dutch Medical Association (RDMA; in Dutch Koninklijke Nederlandsche Maatschappij tot bevordering der Geneeskunst or KNMG)

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The N drink is now a reliable alternative to injection in euthanasia

Professor of applied psychology Pieter Jan Stallen and general practitioner Michiel Marlet investigated over 200 examples of assisted suicide with the N (pentobarbital) drink. This shows that there are no complications with this method.

This is stated by the two doctors in the Dutch Journal of Medicine.

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In addition to the guidelines, several doctors share their personal experiences and preferences regarding the oral and intravenous methods of euthanasia. The reactions of these doctors, which I have translated from Dutch to English, can be found in the journal for Dutch physicians."


I once assisted in suicide using this method, with the general practitioner in the background. My experience was that it went exceptionally smoothly. The patient explicitly wanted assistance in dying. This approach allowed him to be helped in a very respectful manner and in accordance with the law. Indeed, it involved less medicalization, but still with the care and diligence appropriate for such assistance. My experience makes me wonder why this method is not used more often—particularly for individuals seeking dignified assistance in dying.

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I have extensive experience spanning approximately 35 years, and even with a dosage of 9 grams, I have never encountered any failures.

Pentobarbital offers several significant advantages:

It is the most suitable oral substance;

It is 100% reliable;

It causes no unpleasant side effects;

It allows the individual to emphasize their own decision to end their life;

The doctor takes a step back, allowing loved ones to take a more central role;

It significantly reduces the medicalization of the process.

While I also have experience with the intravenous method, it feels uncomfortable to actively end someone's life, especially while they are still connected to the needle.

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After assisting in suicide three times, I have developed a personal preference for this method. It is profoundly dignified and allows for complete self-determination.

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During my career, I consistently preferred the oral method. The fact that the patient takes the medication themselves, rather than passing away "on the needle," and, as my colleague describes, the proximity of loved ones, are all significant advantages in my view.

I recall a situation where the patient's wife struggled with his decision, but the eagerness with which he drank the solution helped her come to terms with his choice.

It has always surprised me how little attention is given to the oral method.

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From multiple experiences, I can confirm that the oral method works exceptionally well and that concerns about failure are entirely unfounded. A dosage of 9 grams of barbiturate is an enormous overdose, ensuring that even in cases of choking, partial spitting out, or vomiting (none of which I have ever witnessed), the patient will still pass away.

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On all three occasions that I have been involved, I was deeply impressed by the courage and determination shown by the patient. For patients who are capable, the oral method should be the first choice.

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I have assisted with euthanasia using the oral method twice. In both cases, it went as described here, with the family members being very satisfied afterward.


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NVVE: Updated information

Now that the current analysis confirms there are no complications associated with taking the N drink, the NVVE (The Dutch Association for a Voluntary End of Life) has updated its information regarding euthanasia options.

The focus should not be limited to the injection method alone. "We are currently grappling with an outdated guideline," the association stated.

The NVVE believes that the method involving the N drink should receive greater attention: "We have updated our information and educational materials to reflect this."

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Source:

The Royal Dutch Pharmacists Association (Koninklijke Nederlandse Maatschappij ter bevordering der Pharmacie, KNMP) is the umbrella organisation for both professional pharmacists and the pharmacy in general.
https://www.knmp.nl/actueel/nieuws/...ing-euthanasie-en-hulp-bij-zelfdoding-herzien

The Royal Dutch Medical Association (RDMA; in Dutch Koninklijke Nederlandsche Maatschappij tot bevordering der Geneeskunst or KNMG)
https://www.knmg.nl/actueel/nieuws/...ing-euthanasie-en-hulp-bij-zelfdoding-herzien

NVVE (The Dutch Association for a Voluntary End of Life)
https://www.nvve.nl/actueel/nieuws/...nasie-en-hulp-bij-zelfdoding-even-betrouwbaar/

EénVandaag is a current affairs programme broadcast on the Dutch public television network NPO 1
https://eenvandaag.avrotros.nl/item...ef-bij-euthanasie-het-is-een-zachtere-methode/

NTvG; English: Dutch Journal of Medicine is the main medical journal in the Netherlands
https://www.ntvg.nl/artikelen/voorkeur-voor-hulp-bij-zelfdoding

Medisch Contact is the professional journal for Dutch doctors.
https://www.medischcontact.nl

Trouw (Dutch daily newspaper)
https://www.trouw.nl/nieuws/dodelij...voor-de-injectiespuit-bij-euthanasie~b3cd8289/

NPO Radio 1: Dutch public broadcasting organisation
https://www.nporadio1.nl/fragmenten...09-25-euthanasie-door-een-drankje-of-injectie

Expertisecentrum Euthanasie, is a Dutch euthanasia clinic
https://expertisecentrumeuthanasie.nl/

Also, can you substantiate your claim on the difference between assisted suicide and euthanasia? Your research is really interesting since my local guidelines read that "An overwhelming majority of Dutch and Canadian patients opt for the IV protocol as there is a 3-10% failure rate with the oral route (though "failure" in some studies means death not occurring within 2 hours)"