Self-destruction of a physically fit person is always a tragic waste of life and hurtful to survivors, but life is a personal responsibility. We must each decide for ourselves.

The medical Power of Attorney is legally enforceable, whereas the Living Will is not. It may seem like a man using both a belt and braces to keep his trousers up, but experience shows that if you care about a good death you cannot be too careful.

The dilemma is awesome. But it has to be faced. Should you battle on, take the pain, endure the indignities, and await the inevitable end, which may be days, weeks, or months away? Or should you take control of the situation and resort to some form of euthanasia, which in its modern-language definition has come to mean “help with a good death”?

Involuntary euthanasia – This is the most controversial way of hastened death, yet it goes on widely and secretly everywhere. Only the Dutch admit to it. It is sometimes necessary when a patient is suddenly, unexpectedly dying in agony, cannot communicate their wishes, and so the attending doctor administers a merciful end.

If you have not already done so, sign a Living Will and have it witnessed, but not by anybody who is going to gain from the Last Will and Testament dealing with your estate. A Living Will, which has nothing to do with property or money, is an advance declaration of your wish not to be connected to life-support equipment if it is judged that you are hopelessly and terminally ill.

This book is chiefly about self-deliverance, assisted suicide, and euthanasia, which the Advance Declarations do not cover. But undoubtedly the very existence of two properly signed declarations would influence health care workers if a question of hastening a death arose. Membership in a right-to-die organization, and having read this book, are at present the two most powerful demonstrations a person can make of sincere beliefs in assisted dying.

Assistance in suicide has never been against the law in Switzerland, Uruguay, Norway, and Germany provided the circumstances were provably compassionate and justifiable. You would be unwise to think of going to one of those countries, because they do not like strangers taking advantage of their laws. Also, the complications of securing your medical care and insurance would be horrendous.

Swiss law since 1937 permits assisted suicide by anyone for altruistic reasons, although it has become the accepted practice that first there must be a doctor’s agreement and only lethal drugs can be used, taken orally – no injections. Reporting the “terminal suicide” to the police is normal procedure – nothing secretive. The Swiss do not rule out visitors provided they meet the time-honored criteria – a dying, competent, adult, and a local doctor after examination agrees they are terminal.

There are a few people who tell me that they are so used to a solitary life that they will die alone, but even here I advise them that if they are thinking of self-deliverance the chances of the action not being botched are much better if a friend is present.