Euthanasia

**Euthanasia** is an unlockable passive item added in *The Binding of Isaac: Afterbirth †*.

## Effects

* Adds a chance to fire needles which deal triple Isaac's tear damage.
	+ Needles will instantly kill regular enemies and cause them to burst into 10 more tears in all directions.
	+ The chance to fire a needle depends on luck.
	+ The formula used to determine the chance is:

	1

	30
	−

	⌊

	L
	u
	c
	k

	∗
	2

	⌋

	{\displaystyle \frac1 { 30 - \left \lfloor \mathit{Luck} \* 2 \right \rfloor}}

		- At base luck (0), the chance is 3.33%, maxing out at 100% at 14.5 luck.
	+ The formula used to determine the chance is:

	m
	i
	n
	(

	1

	30
	−

	⌊

	L
	u
	c
	k

	∗
	2

	⌋

	,
	25
	%
	)

	{\displaystyle min(\frac1 { 30 - \left \lfloor \mathit{Luck} \* 2 \right \rfloor},25\%)}

		- At base luck (0), the chance is 3.33%, maxing out at 25% at 13 luck.
	+ The tears released upon an instant-kill *also* have a chance to be needles, though these ones *do not* have the instant-kill ability. They do retain the 3x damage, however.
* This item belongs to the  set. Collecting three items from this set will transform Isaac into a buff berserker.

## Notes

* The needle tears can kill enemies that are normally invincible, such as Peep's eyes, Death's Heads, and Stoneys.
* The needle tears can kill Stone Grimaces and  Spikeballs, allowing Isaac to permanently remove any obstacle in a room.
	+ The needle tears can kill Bomb Grimaces, dropping 10 unlit Throwable Bombs. This can make it detrimental to shoot at them, since they are usually provided as a tool rather than an obstacle.
* The tears in the burst are larger than normal but do not have a damage bonus.
* Unless piercing is obtained, Knights will still block the needles if shot from the front.

## Interactions

* /  /  /  / : No appearance change, tear burst, or instant kill, but triple damage still works.
* / : Enemies killed by a needle burst into normal tears.
* : The aura of a needle tear will also do triple damage, but does not cause tear burst or instant kill.
* : No tear burst or instant kill, but triple damage still works.
	+ Enemies killed by a needle burst into ipecac shots.
* : The electric arcs released from a needle shot also retain the needle's instant kill and tear burst properties.
* : If a tear has both the Euthanasia and Little Horn effects and instantly kills an enemy, it does not cause a tear burst.
* : The tears that Isaac fires work normally, and the laser has a chance to deal triple damage with no other effects.
* : Completely overrides Euthanasia. No triple damage, no tear burst, or instant kill.
	+ Laser Rings will sometimes deal triple damage/instantly kill regular enemies, and enemies killed by needles burst into normal tears.
* : Killed enemies can burst into black tears normally.
* : The tears that Isaac fires work normally, but the laser is completely unaffected.
	+ The laser has an extremely high chance of executing normal enemies.
* : Each swing of the sword has a chance to do 3x damage and instantly kill a non-boss enemy, causing a tear explosion.

## Trivia

* Euthanasia is the act of intentionally ending a person or animal's life to end their pain and suffering. It is usually carried out by an injection, hence why this item has the appearance of a needle.
* Euthanasia is the only syringe item that points upwards; all of the other syringes point downwards.
* Euthanasia and  are the only 2 syringe items that need to be unlocked.