I get you, it's certainly a heavy act. But ultimately, it's a mercy. Certain specializations of healthcare require a certain mindset, and this would be one of them, much more so than most

I'm totally convinced you're coming at this from a place of empathy for all involved, and I understand why you feel that way. I don't have a clean answer... I spent a lot of time in the hospital as a child (as a relative of staff), and I grew up eating dinner while seeing surgery pictures and hearing pretty disturbing events described with gallows humor.

I'll just share my thoughts on it - I'm not trying to convince you so much as give perspective about the attitudes held by the doctor/nurse handing over the drink. They don't see it the way you would - it's part training, part coping mechanisms, and part conviction that brought them there

A family member of mine used to work in the ICU and geriatrics... Not many roles where you're going to see more pain and death. People die a lot, and it might've been your job to save them.

How do you go home and live your life like that?

You accept you did the best you were able to at that moment. You lessened their pain, and helped them pass as peacefully as you could. You showed them care in their most vulnerable moment. You gave them dignity.

She literally cleaned shit off dying people on a daily basis. They would lash out at her and act like toddlers, because they're afraid and in pain. She'd make a connection with many of them, knowing they could pass while she's out on a date.

Sometimes, they would have no one. They might be confused and she'd be a soothing voice they can't understand, sometimes they'd give her their final words and regrets, and thank her for not letting them be alone.

She chose to specialize in this, specifically. When I asked her why, she told me all of that with a smile... She's the only one in my family (of many) who was drawn to this. Most of them decided to go for children, and when they were forced into situations like this (early on their careers, when they didn't have much choice), they'd mostly grimace remembering it and say they'd have quit medicine altogether.

It takes a very specific type to do this for long. Most are fueled by hope at a happy ending or just as a career... End of life care has no hope or happy ending, it's just to ease suffering.

I get your concerns, but helping them end their lives on their own terms is why they'd go into that specialty. Whatever their specific beliefs, they're in that position because they were drawn to it. It's controversial (meaning personally dangerous), emotionally challenging, and tedious process/bureaucracy.

It's also very specialized... Not any medical professional can just jump into the role. They had to have sought it out

As for why not injection... Partially, it's probably because what if it goes wrong? IVs can slip, blow out a vein, the mechanism could fail... And it's also much more direct than giving them a cup. They could've mixed up something. It probably would've been more painful, terrifying, and more likely to end with them surviving with a much lower quality of life.

There's also more dignity - they can be anywhere, without being covered in tubes and wires.

The ultimate question is: is this what's best for the patient? Because that's what they hang into - that's what lets them keep going, what lets them wake up and do it tomorrow

This was a pretty stream of consciousness reply, it's a vague concept to put into writing, and I mostly only know it second hand. Hopefully some of it got through