The Right to Die: Is Euthanasia Changing Status from an Arduous Conundrum, to a Luxurious Liberty?

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The Supreme Court of the Netherlands aimed “to give direction to euthanasia law-making”, through its new ruling, passed on 21st April 2020.

Doctors in the Netherlands are now legally permitted to euthanise patients with advanced dementia, provided there is a written request for the procedure and requirements by the law are met- even if the patient is in an unfit condition in which they cannot confirm their wish to die. This decision stems from the criminal case against a nursing home doctor who aided a 74 year old woman suffering from severe Alzheimer’s, to die in 2016. This landmark case absolved the doctor of any wrongdoing. The patient had written an advance directive stating her request to undergo euthanasia, prior to her admission into a care home, by stating, “while still in my senses and when I think the time is right”. In this example, a doctor decided the procedure was fitting and this was also confirmed by two other doctors.

Prosecutors felt there was no explicit consent given to end the patient’s life, as following her admittance to the home she gave “mixed signals”. Although she had taken a sedative in her coffee, the woman’s family had to restrain her as she was euthanised.

[1] According to the statement made by the Supreme Court, “A doctor may respond to a written request for granting euthanasia to people with advanced dementia. In such a situation, all legal requirements for euthanasia must be met, including the requirement that there is hopeless and unbearable suffering. The doctor is then not punishable”. Furthermore, “Even if it is clear that the request is intended for the situation of advanced dementia, and that situation is reached so that the patient is no longer able to form and express a will, there can be circumstances where no follow-up on the request is possible”. Therefore, even if the individual is not in the condition to make a decision to end their life, it is legal to follow through.

The Netherlands have always been at the forefront of Euthanasia, taking on challenges which come with one of the most controversial, yet necessary tools for the development of modern society. The pioneering work put into the reformation of this section of medical law, carefully considers the critical rights of autonomy that are essential to our generation and those forthcoming. It began with the 1973 “Postma case”, in which a physician was declared guilty of an offence after having assisted her mother’s death who repetitively and explicitly asked to undergo euthanasia. In 2001, the ruling legalising euthanasia was passed, and as of March 2018, it is legal in Belgium, Colombia, Luxembourg and Canada. Legislation in Switzerland, some states in the US and (as of February 2020) Germany, has led to the allowance of assisted suicide (PAS- Physician Assisted Suicide).[2]

It has always been emphasised however, that euthanasia is only allowed if: there has been a voluntary request, it has been considered by more than one doctor, the patient is under the condition of “unbearable suffering without any prospect of improvement,” and there is a lack of a “reasonable alternative,” according to the Royal Dutch Medical Association.

The provision of this procedure has been steadily increasing, with the youngest euthanasia patients being nine and eleven, the youngest of whom had a brain tumour and the other child was suffering from cystic fibrosis. Those with severe mental illnesses are able to meet the criteria, regardless of whether they are in perfect physical health; a high profile case being 38 year old Eelco de Gooijer who has been cited as an example of euthanasia at its best, according to the NVVE. [3]

For many, euthanasia is a means of ending suffering and an essential right, but why do the UK, and many other countries, oppose the legalisation of it? In the UK, the Care Not Killing alliance worries this could result in elderly or vulnerable people being under greater pressure to end their lives to remove the burden on loved ones. Disability Rights UK also oppose the legislation as the choice to die could be “an illusory choice” in cases of disabled people not being offered proper support. The British Medical Association (BMA) agree to improving palliative care to allow patients to die with dignity, but oppose any physician assisted suicide, “as the principal purpose of medicine is to improve patients’ quality of life, not to foreshorten it”. [4]

As the definition of “unbearable suffering”, crucial to the law, has loosened in countries where euthanasia is legal, differing opinions of doctors and the general public have been unveiled. Despite any amount of legal clarity, there is much weighting placed on a doctor’s personal moral compass and their subjective ideas of what their interpretation of “unbearable” is. Agnes van der Heide, Professor of Medical Care and end-of-life decision-making at the Erasmus Medical Centre in Rotterdam, concludes that along with euthanasia, rises the opposition between the right of the individual and society’s obligation to protect lives.


References

  1. (April 2020) Dutch court allows euthanasia in advanced dementia cases. Last accessed April 26, 2020 from https://edition.cnn.com/2020/04/22/europe/netherlands-euthanasia-dementia-intl-scli/index.html
  2. (April 2020) Legality of euthanasia. Last accessed April 26, 2020 from   https://en.wikipedia.org/wiki/Legality_of_euthanasia
  3. (January 2019)  Death on demand: has euthanasia gone too far? Last accessed April 26, 2020 from https://www.theguardian.com/news/2019/jan/18/death-on-demand-has-euthanasia-gone-too-far-netherlands-assisted-dying
  4. (February 2019) What’s the difference between assisted suicide and euthanasia? Last accessed April 26, 2020 from    https://www.bbc.co.uk/news/uk-47158287

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11 Replies to “The Right to Die: Is Euthanasia Changing Status from an Arduous Conundrum, to a Luxurious Liberty?”

  1. Excellent …. And relevant keeping in view today’s time

  2. Right to die is as fundamental a right as a right to live , with respect, with dignity . Unfortunately the law does not allow you to go beyond a certain limit of decision making and i , as a doctor, have been through this situation multiple times , personally I believe that every life should be valued and at a certain point decision making should be In hands of doctors if the life should continue ,no matter how ruthless it may sound but a miserable life , a hopeless life , if discontinued with medical help should not be considered as crime .

  3. Excellent cover…
    Because you can’t heal wound, just kill it!! Doctor should try to heal the wound.

  4. A very nicely written article on a very important topic. Impressed with lots of Legal etiquette used.
    One of the reason (at least in some countries) not to implement is mis-use of this law. I still believe, every government across the world should give a thought on implementing this law.
    Finally, what is the author’s opinion ?

  5. It would discourage the search for new cures and treatments for terminally ill.

    1. I’d have to disagree. The article’s emphasis on the doctor’s moral compass and the weight of such an important decision highlights the fact that doctors would wish the avoid euthanasia wherever possible. It goes without saying that doctors and patients alike would rather receive a cure than a funeral, and so researchers will continue to search for new cures and treatments regardless of whether euthanasia is legalised or not.
      Moreover, medical societies clearly state that euthanasia is only a viable option where there is a lack of a “reasonable alternative”. Euthanasia would provide a peaceful escape for those suffering from terminal illnesses until researchers and doctors can find a cure.
      Essentially, euthanasia would not discourage the search for new cures and treatments, but provide an end to patients’ suffering, until the time comes when there is a successful cure so that future patients no longer need to consider assisted suicide as an option.

  6. A very well researched, structured and contexted opinion.
    Interesting and simply presented information for a layman with respect to both medical and lawmaking norms.
    Thank you for the insight into the topic of legality of euthanasia.

  7. Excellent article. Kudos. Highly debatable topic.

  8. Very well written article, putting differing perspectives together. A very serious subject, and open to debate as the subject carries a very strong emotional quotient. One of those cases where the line between what is right vs wrong is not necessarily easy to draw. Great effort by the author to trigger some soul searching. And I have the same comment as Santosh Kundar … wonder what is the author’s take on this subject?

    1. Thank you all!
      I won’t, however, be disclosing my personal take on the issue as our articles are primarily informative- nonetheless thank you so much for your comments.

  9. A thoughtful one on a very delicate subject.
    The moral aspect of it is highly debatable and one may not arrive at an easy conclusion.
    Its even more difficult to make laws around an issue like this where people around the world are highly divided on what’s moral and what’s immoral.

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