Saki Hirayama (5th grade)

From August 3rd to 10th, 10 fifth graders went to Seattle, USA. There, they had the opportunity to receive valuable lectures from teachers including Mr. King and Mr. McCormick.
First of all, the reason why I decided to go to the University of Washington for training was that ever since I entered Hyogo Medical University, I had vaguely thought about studying abroad while I was a student. I thought that I should go abroad while I was a student and had plenty of time to broaden my horizons. However, in the actual life of a student, it is difficult to find time, and if you don't pay attention, time just passes by. At that time, I found out about this training program, and it was a godsend for me. I am grateful for the miracle of having come across this wonderful opportunity.

Every day in Seattle was a learning experience and a special one. I visited not only the University of Washington, but also Seattle Children's Hospital, Seattle Cancer Care Alliance, Providence Hospice of Seattle, Northwest Kidney Center, and Harborview Medical Center, and received very valuable lectures at each facility. I would like to introduce some of the most memorable ones.

Dr. Green gave a lecture on euthanasia. Washington state is the second state after Oregon in which euthanasia is permitted as of 2019. It seems that the number of barbiturates (lethal drugs) prescribed in Washington state is increasing year by year. Just looking at this fact, I think you can understand the necessity of euthanasia. The target age is 18 years old or older, Washington state resident, and life expectancy is less than six months. Patients make requests three times. The second and third requests must be in written consent. Then, if the first doctor agrees, he or she will ask a second doctor to diagnose the patient's life expectancy. If the second doctor also diagnoses that the patient has less than six months to live and the two doctors agree, the patient will be able to safely receive euthanasia. Doctors can refuse this decision, and in that case they are obligated to refer the patient to another doctor. Doctors can prescribe barbiturates to patients and place the drug near the patient or even hold it on their hands, but it is up to the patient to decide whether or not to actually take it. There are no regulations regarding dignified death in Japan, but here is a story about a patient who died with dignity that a doctor experienced. The patient was a terminal cancer patient who wanted to die on the terrace over the lake in his house while watching the sunset. The patient invited the doctor to join him on the terrace and drink wine while being lit by the sunset, and finally received his medicine from the doctor. He died about 30 minutes after taking the medicine with the wine. The doctor who treated this patient said that this experience had deeply moved him. However, when asked if he wanted to prescribe barbiturates again, he said that he did not want to do so again. In fact, many doctors who have prescribed barbiturates once say that they do not want to prescribe them again. At first, I did not understand this feeling, but it is true that we aim to become doctors to save people, not to kill them. It seems that we who are left behind will need more time to believe that dignified death is saving people.

Finally, we would like to thank Dr. Yamanishi of Hirakata Rehabilitation Center for providing us with so many valuable experiences, Dr. Seki and his wife, and Dr. Gamo, who accompanied us even though we didn't know what to do, Dr. Kondo and Dr. Nakamura, who protected us so that we could complete the training safely, and Ms. Sakurai and Ms. Umezawa, who managed the training smoothly. We are also deeply grateful to Dr. King and Dr. McCormick, who welcomed us warmly in Seattle and provided us with so many wonderful lectures, and to Ms. Turid and Ms. Yoshiko, who helped us deepen our understanding. Thank you so much for allowing us to participate in this wonderful training.