Euthanasia: International debate on the choice of death

“Historic significance” but also a “step towards the unknown” characterized most British newspapers as the result of passing the bill on assisted voluntary death by the House of Commons last week.

Although it is still not in its final form, the purpose of the bill is to allow British adults who have the necessary mental capacity and are sick at a final stage with life expectancy of up to six months to be entitled to seek help from a doctor to die. Of course, there are criteria to be met by the patient and which will be confirmed by at least two independent doctors, but also “security panels” to ensure that the patient’s decision is voluntary.

After intense weeks of debate, 330 British MPs voted in favour. Thus, with a slight difference of 55 votes the right to assisted voluntary death took the first step to apply to England and Wales. Of course it takes several more parliamentary steps until it becomes the law of the British state, while even if that happens, it can take up to two years until finally implemented, explains “Guardian”. However, this bill, according to a poll by YouGov, is based on 73% of citizens, while at the same time being one of the “significances” of the Kir Starmer Workers’ Party and comes to line up with a number of western countries that have secured this right for their citizens – and not only.

Unlike euthanasia, in the case of medically assisted suicide it is the patient himself who puts an end to his life rather than a third person, e.g. a doctor. In this case, the doctor has the role to give the patient the necessary means, i.e. the lethal substance.

Labour MP Kim Lindbeater, who brought the bill to the House, argues that this is how “choice and dignity are given to patients who are in final stages”. Although generally the right to a decent death divides, for its champions the issue primarily concerns the right of man’s freedom to control his body and to be free from unbearable pain when his quality of life has deteriorated dramatically. Decent death shows no lack of humanity, they point to relevant international organizations, instead it shows care and respect for the patient’s wishes. On the other hand, there is no shortage of those who fear that if the law is approved its use will be extended, some of the restrictions will be lifted and the pressure on older people, disabled people or severely ill people will put an end to their lives, due to fear and regrets that they have become a burden on their families or society.

Moreover, both in the British Parliament and in the public debate dominated the argument that the assisted death should not serve as an excuse for less care for these vulnerable persons, but instead the state should be able to ensure them dignity in their last years.

There is still the issue of cost and whether the National Health System will handle it, but there are ethical issues, since some health professionals have expressed objections to their involvement in ending patients’ lives.

In total, some 300 million people around the world are legally entitled to put an end to their lives in a form of assisted death. In Europe, the first countries to legalise euthanasia were the Netherlands and Belgium in 2002. These are the two countries where the highest euthanasia rates are noted: in 2021 2,700 euthanasias were recorded in Belgium (2,4% of the total number of deaths), while 8,720 incidents were recorded in the Netherlands (51% of all deaths). In Luxembourg, euthanasia and medically assisted suicide have been legal since 2009.

Even in European Catholic countries, where the Church’s reactions were fierce with the argument that God decides on human life, there are relevant legislation. In Austria the Law on Medically Aided Suicide entered into force in 2022, in Italy it has been in force since 2019, Spain enacted corresponding legislation in 2021 and May 2023 the Portuguese Parliament has decriminalised this practice. A relevant debate had also begun in the French Parliament last spring at the initiative of President Emmanuel Macron.

In Switzerland, medically assisted suicide has been legal since 1942, but not euthanasia. However, unlike most other countries, it does not limit its criteria to the citizens of the country, which had made it the first destination for patients from all over Europe seeking help to end their pain – to the extent that the development of the so-called ‘suicide tourism’ caused discontent in Swiss society. However, the authorities decided in 2011 not to restrict practice.

At international level, Australia and New Zealand have corresponding laws, but Canada was the first Commonwealth country to uphold respective rights for its citizens. In fact, it has the most liberal legislation on euthanasia and medically assisted suicide, and the government of Justin Tridot plans to extend the right to mentally ill sufferers.

In the U.S. the State of Oregon set an example, as the first to legalize the assisted death in 1997. Since then 10 other States followed, based on it.