Euthanasia

Why do patients in palliative care units request euthanasia when they know it is illegal? Euthanasia requests appear to be a willful means to remove oneself from the impasse of an existence paralyzed by suffering. It creates a space for discussion. Firstly, the study showed that patients requesting euthanasia within a PCU were unaware of or tended to ignore the difference between palliative care and euthanasia. Whatever the legal context of euthanasia, this confusion demonstrates the significant evolution of the societal representation of palliative care. Second, the request for euthanasia can constitute a call for help. If this is taken properly into consideration, it can decrease the overall suffering or even hinder the move to a suicidal act.

Source

The systematic review published by Cambridge University in June 2022 do not support the claims made that the introduction of EAS results in reduced rates of non-assisted suicide. Several studies reported increases in overall rates of self-initiated death and, in some cases, increased non-assisted suicide, although this latter increase was generally not significant when sociodemographic factors were controlled for. The studies based in Switzerland and Oregon suggest that older women might be disproportionately vulnerable to EAS where this is legislated for, and when the higher rates of depressive illnesses among women are considered, this may indicate a need to address suicide prevention more assertively in this population.

Source

On May 31, a royal decree amended the law relating to euthanasia in Spain. Since its legalization on March 18, 2021 (cf. Spain legalizes euthanasia and assisted suicide), the procedure was regulated by a decree published on February 2, 2022. With this revision, the request for euthanasia can be made by “a third person”, parent or doctor, if the patient no longer has the capacity to decide for himself and has formulated advance directives to this effect.

Source

In Quebec, the Minister of Health had to face the facts on Thursday: the examination of the extension of “medical assistance in dying” to patients suffering from Alzheimer’s disease requires more time than the deputies had it before the end of the parliamentary session on June 10. Bill 38 consisted of about fifty articles. In particular, he would have authorized “advance requests” for “medical assistance in dying”, for patients with “serious cognitive disorders”. It had been tabled at the end of May, following recommendations issued by a cross-partisan commission in December. The resumption of parliamentary work is scheduled for October.

Source

In a webinar, Henri de Soos, lawyer describes 2 methods employed to legalize euthanasia. The first one consists of multiplying the legislative proposals to stimulate a national debate and ultimately obtain a majority vote. The second method consists of obtaining a judgment from the constitutional court to oblige the government and the parliament to decriminalize euthanasia or MAD. It was implemented for the first time in Canada, then between 2019 and 2020 in Italy, Germany and Austria. In these 3 countries the judges have interpreted their constitution in a new sense and declared that henceforth, assisted suicide could not be prohibited. The parliaments concerned are thus obliged to create a mechanism to make this possible in the months to come.

Source

A survey conducted by Professor Yoon Young-ho at Seoul National University Hospital showed that 76.3 % of Koreans favored euthanasia or doctor-assisted suicide. Reasons for approval included meaninglessness of life extension (30.8 %), patient’s right to have a death with dignity (26 %), alleviation of pain (20.6 %), family suffering (14.8 %), alleviating social burdens (4.6 %), and that it does not violate any human rights (3.1 %). In contrast, 23.7 percent opposed their legalization. The opponents cited respect for life (44.3 %), infringement on the right to self-determination (15.6 %), the risk of abusing the system (13.1 %), violating human rights (12.2 %), the possibility of doctors’ misdiagnosis (9.7 %), and recoverability (5.1 %).

Source

The Dutch Council of State has rejected a draft “death wish” assisted suicide bill that seeks to extend existing legislation to over-75s who are “tired of life”. The Council of State, the highest-ranking advisory body in the Netherlands, previously released a report on the bill, explaining that the “government has a duty to protect its citizens against involuntary, hasty or ill-informed decisions about ending their lives and to prevent abuse”. “In 2020, 53% of people killed by assisted suicide in the US state of Oregon said that they feared “being a burden on family, friends/caregivers” if they continued to live. In Scotland, too, 36% of over-50s recently reported they were seen as a “burden” by others, as reported by SPUC.

Source

On 19 May 2022 the Voluntary Assisted Dying Act 2022 (NSW) was passed by the New South Wales Parliament.  Voluntary assisted dying (VAD) is a major legal, ethical and social policy issue. In Australia, VAD laws have been passed in all States. Victoria’s and Western Australia’s VAD laws have commenced operation. VAD will commence in Tasmania on 23 October 2022, South Australia in early 2023, and Queensland on 1 January 2023. The date for commencement of New South Wales’ laws is to be confirmed, but will likely be in late 2023/early 2024.This webpage discusses the laws on VAD both in Australia and internationally, and their intersection with palliative care and medical treatment decision-making.

Source

In 2015, a terminally ill Robin Stransham-applicant asked for the “right to die with dignity”. Judge Fabricius of the North Gauteng High Court found that he had a constitutionally protected right to do so. The applicant passed away a few hours before the judgement. Supreme Court concluded that assisted suicide is not unlawful in all circumstances. Nevertheless, the judgment of Prof. Sean Davison in 2019 shows that euthanasia is still unlawful in South Africa. In fact, he received a suspended sentence of 8 years with house arrest and community service for having assisted 3 patients in dying. Very recently, a new case involves a palliative care specialist and one of her patients, both with terminal conditions.

Source

151 Dutch case reports on euthanasia in dementia (2012–2020) were analyzed. In 2011, the first advanced-dementia-case has been authorized. The reported numbers amounted from 5 in 2005 to 170 in 2020. Ethically relevant is the prevalence of psychological and spiritual suffering (99.1% and 84.7). The study questions the factors of euthanasia requests: How voluntary is a request? Can an incapacitated patient make well-considered requests? What constitutes “unbearable suffering”? How (well) can a patient with cognitive limitations be informed? To conclude, the importance of narrowing the gap between perceived and real nursing home quality, making information about end of life options and involving patients’ own physician in a euthanasia request are highlighted.

Source