Assisted suicide advocates are seeking to legalise the practice in Spain and Portugal while expanding the availability in Canada and Germany.
Euthanasia-on-demand could become available in Canada and Germany for the majority of the general population, showcasing how, once introduced in law, assisted suicide regimes often expand significantly either through the courts or parliament.
Canada
The Canadian Government has tabled a bill that, if approved, would expand the country’s assisted suicide regime to include people without a terminal illness.
The legislation comes after the Quebec Superior Court ruled last year that a safeguard requiring patients to prove their natural death was “reasonably foreseeable” was unconstitutional.
According to Reuters, the bill will now “remove the requirement for a person’s natural death to be reasonably foreseeable in order to be eligible for medical assistance in dying,” opening up assisted suicide to those who aren’t terminally ill.
Disability advocates, including the Council of Canadians with Disabilities, have said the court’s decision sent the message that “having a disability is a fate worse than death”.
A recent report by the Special Rapporteur on the rights of persons with disabilities in Canada highlighted very troubling concerns about the impact Canada’s assisted suicide laws are having on people with disabilities.
According to the report, “The Special Rapporteur is extremely concerned about the implementation of the legislation on medical assistance in dying from a disability perspective. She has learned that there is no protocol in place to demonstrate that persons with disabilities deemed eligible for assistive dying have been provided with viable alternatives.”
The report goes on to say: “moreover, she [the special rapporteur] has received worrisome information about persons with disabilities in institutions being pressurised to seek medical assistance in dying and of practitioners not formally reporting cases involving persons with disabilities.”
During her visit, the Special Rapporteur said people with disabilities told her “they are being offered the ‘choice’ between a nursing home and medical assistance in dying”.
More than 13,000 Canadians have been given a medically-assisted suicide since it was legalised in September 2016, according to the data from the justice department.
Ethical concerns were raised earlier this year when it was revealed the legalisation of assisted suicide in the country had resulted in a surge of organ donations and the open solicitation of those considering medically assisted death.
In Ontario, a hospital has faced criticism for advertising euthanasia in an urgent care waiting room.
An alarming study has found that the legalisation of assisted suicide could save the Canadian health care system up to $138 million per year.
According to the Alzheimer’s Society of Canada, over 500,000 Canadians live with dementia, with 25,000 new cases diagnosed each year. It currently costs more than $10 billion per year to care for those in Canada’s health system.
Germany
A five-year-old law banning professional assisted suicide in Germany has been declared unconstitutional by the country’s top court.
In 2015, Germany’s parliament voted to amend paragraph 217 of the country’s criminal code to add in safeguards preventing groups or individuals creating a form of business that profited from assisted suicide.
However, in its ruling on Wednesday, the Federal Constitutional Court declared Germany’s constitution includes a right to a self-determined death which encompasses the freedom to take one’s own life and use assistance provided voluntarily by third parties.
The Government must now draw up new laws to reflect the legality of assisted suicide in the country.
The German Medical Association opposed any relaxing of Paragraph 217, warning it could open the door to euthanasia, where doctors take an active role in helping a patient die – for example through lethal injection.
The head of Germany’s Palliative Medicine Society, Heiner Melching, said that overturning the ban on professional assisted suicide could also open the door to “self-styled euthanasia assistants”.
The court stressed however that legislators still had “a broad spectrum” of options to regulate assisted suicide, for instance through mandatory waiting periods or through introducing other safeguards in law.
Portugal
Last week, Portugal’s parliament moved closer to legalising assisted suicide and euthanasia after voting in favour of five “right-to-die” bills.
The details of the bill will now be discussed in detail and amended by the parliament’s constitutional affairs committee, after which it will be subject to a final vote.
President Marcelo Rebelo de Sousa can veto any new law passed by the Government, but the country’s parliament can override his veto by voting a second time for approval.
Francisco Guimaraes, a 21-year-old protestor, told Reuters that he believes “life is an inviolable asset, human life has an inviolable value, consecrated by our Portuguese constitution.”
“We must care for life until it comes to its natural end,” he added.
Spain
The lower chamber of Spain’s parliament, the Congress of Deputies, has voted in favour of considering a bill that would legalise assisted suicide and euthanasia in cases of “clearly debilitating diseases without a cure, without a solution and which cause significant suffering.”
The bill will now go to the upper chamber of Spain’s parliament, the Senate, for a final vote with assisted suicide activists hoping it will be approved by June.
Rocio Monasterio, the leader of the Madrid branch of the Spanish political party Vox, told Reuters her party would mount “fierce” resistance to the bill, which she said would allow people whose life was no longer considered useful to be “eliminated”.
A spokesperson for Right To Life UK, Catherine Robinson said:
“You can learn a lot from paying close attention to countries and other places where assisted suicide and euthanasia has been legalised. What we often see is that death soon starts to appear as an all-too-acceptable solution to all sorts of conditions and, alarmingly, emotional situations.
“Every year there is a significant increase in the number of people being euthanised or helped to commit suicide by their doctors. This is compounded by the fact that once assisted suicide has been legalised for one category of people, it is often only a matter of time before it is extended to others, whether it is imposed through the courts or Government.
“In Belgium and the Netherlands doctors now routinely end the lives of patients suffering from psychiatric illness, with no underlying physical illness.
“Recently, The Telegraph and the Daily Mail reported that a Dutch family held down their mother as she fought against being euthanized by her doctor.
“Cases like these aren’t one off rarities but are becoming commonplace and have even prompted Theo Boer, a medical ethicist at the University of Groningen, to issue a warning to countries considering legalising assisted suicide and euthanasia.
“‘Look closely at the Netherlands because this is where your country may be 20 years from now,’ he said.
“Furthermore, evidence from Canada demonstrates how a so-called ‘right to die’ can become a ‘duty to die’. Feelings of being a burden were cited in 55% of Oregon and 56% of Washington assisted-suicide requests in 2017.
“This is especially the case when families and health budgets are under financial pressure, which makes the Canadian study which found that the legalisation of assisted suicide could save the health care system more than $138 million per year so alarming.
“Legalising assisted suicide would likely lead to pressure on vulnerable people to choose the quicker, cheaper option of death over palliative care.”
