Yet the relief when all goes according to plan is commensurate and that, as Keizer says, provides the job satisfaction.Then there are the relationships between doctors, nurses, priests, patients and their families, as well as the inter-relationship between the three doctors working at the nursing home. Bert Keizer, or ''Anton'' as he calls himself here, is the middle one of the three in both age and attitude, standing between a laconic old-timer called Jaarsma and the recently-qualified and still starry-eyed De Gooyer. I mean, don't do it because it's so hard on the spectators to have to watch the suffering".Timing is everything. Patients may leave it too late: they may be beyond asking for it, however much they might desire it. Keizer points out that there's no answer to the question, "When should you end your life?'' Often it's only "when it's too late [that] you know when you should have done it''.

Keizer's "First Commandment'' is: "Don't ever terminate a life for cosmetic reasons. And it is but a step from that axiom to a more generalised theory, that it is the people who don't pay for what they eat, and don't care what they eat (but make a big fuss about it), who destroy food for the rest of us. As Keizer indignantly tells one stroppy patient who demands it: "You can't order that like an omelette, you know.'' Leaving aside legal considerations (and the law in Holland is obviously more liberal than here), doctors have to be sure that the patient's death wish is not a passing whim, and that it is justified by the hopelessness of his or her medical condition. He is also humane: as considerate and gentle in action, it would seem, as he is verbally aggressive and opinionated. A witty man, too: Wilde is another of his literary idols.Sylvia Plath (not quoted here) famously wrote: "Dying / Is an art, like everything else.

I do it exceptionally well.'' Helping others to die is also an art, and nobody who reads this book could possibly go away with the idea that euthanasia is an easy option - for anyone, either the dealer of death or the recipient. He is not averse to having the last word either. But above all this is an examination of the use of euthanasia in modern medicine, a meditation on helping people to die. The handling of this theme is what makes the book so impressive and timely. Keizer is not only clever and widely-read - he took a degree in philosophy at Nottingham University before turning to medicine. It is a rich confection of thoughts on what Keizer calls "the sadly underrated and ignored history of medicine, the nature of the quarrel with alternative medicine, the placebo effect, the meagre scientific content of medical practice, the failure of cancer research, the anatomical ideas of the average citizen, the incredible overestimation of the power of medicine, the things people do to allay their fear of death, the inscrutable ways our minds are anchored to our brains (to have a mind - to be a body)'', and so forth.