Euthanasia: Can Dying Truly Be a Free Choice?

Euthanasia: Can Dying Truly Be a Free Choice?

Euthanasia is becoming an increasingly common legal option in the Western world. The former Dutch administration, led by liberal Mark Rutte until his recent resignation, expanded access to euthanasia for terminal patients ages one to twelve years old – with their parents’ consent. While in New Zealand, 65% of voters voted in favor of euthanasia last October. In Switzerland, the practice has been around for some time and can cost up to €10,000.

The legislation of various countries around the world shows us a diverse cultural cross-section, and the debate becomes even more complicated when we talk about minors. The Dutch Minister of Health, Hugo de Jonge, a member of the so-called Christian-based party, the Christian Democratic Appeal, announced last fall that an agreement had been reached to extend the euthanasia law to children up to the age of twelve. The basis of this choice was a study on the suffering of children, according to which "there is a need for an intentional interruption of life" decided in agreement "between doctors and parents" to help "a small group of terminally ill children who suffer hopelessly and unbearably." The Minister estimates there are between five to ten cases per year of this sort: it’s a method applicable to "exceptional and circumscribed cases."

In the Netherlands, the euthanasia law has been in place since 2002, while in New Zealand it has been in effect since the October 17, 2020 referendum with which the citizens also confirmed the Labour Party Prime Minister Jacinda Ardern. The legislation had already been approved in parliament the year before, but the government waited for the people's vote to make the law effective. Under the new law, an adult of sound mind suffering from an incurable disease that could cause him or her to die within six months, and whose suffering is "unbearable," can request a lethal dose of medication. The request must be signed by the patient's physician as well as an impartial doctor – in addition to a psychiatrist's consent if there is any doubt about the person’s ability to make a rational decision. Justice Minister Andrew Little announced that the law will be effective as of November 2021.

In Spain about a year ago, the introduction of a euthanasia bill put forth by the PSOE (Spanish Socialist Party) was approved –– with 210 votes in favor, 140 against, and 2 abstentions. In a March 2020 TV interview with Spain's leading expert in palliative care, anesthesiologist Marcos Gómez Sancho, who is – among other things – former president of the Sociedad Española de Cuidados Paliativos (Secpal), stated that out of 25,000 patients treated in his long professional career, only three or four had expressly requested euthanasia after beginning palliative care.

"When patients come in – says the doctor- plagued by the pain of cancer such as that of the pancreas, they normally ask to be allowed to die. After the first morphine shot, they stop asking that. If you start palliative care, the request doesn’t come up again except in very rare cases: three or four out of the 25,000 people I have treated in 28 years. The problem in Spain is that there is too little palliative care. 120,000 patients a year need it, but only half receive it. There is no investment in palliative care because it does not draw the spotlight, as transplants do is not as. It is a scandal that a law is being passed to end the lives of the sick." This stance highlights an important reality: people decide they want to die because they are suffering too much physical and mental pain.

But what if they were not in distress? Demands for euthanasia would probably drop, or at least that's what the medium- to long-term data indicates.

Is untreatable synonymous with incurable?

In 2019, 6,361 people died by euthanasia in the Netherlands, accounting for 4% of all deaths: 91% were patients considered terminally ill, with the remaining cases relating to people suffering from serious mental disorders, such as depression.

In order to identify children who have a "right to die," certain conditions must be met: "no prospect of recovery and intolerable suffering" are generic concepts left to interpretation. In Belgium, law permits child euthanasia. We refer to two cases of death for children ages nine and eleven in 2016 and 2017. In Switzerland, assisted suicide is allowed –– a practice in which doctors accompany the subject until they take a drug that first puts them into a deep sleep and then, half an hour later and in total unconsciousness, sends them into cardiac arrest.

Last September, the Congregation for the Doctrine of the Faith in its letter Samaritanus Bonus, dedicated to the "care of persons in the critical and terminal phases of life," expressed in no uncertain terms the immorality of euthanasia. “The Church believes that it must reiterate as a definitive teaching that euthanasia is a crime against human life because, with such an act, a man chooses to directly cause the death of another innocent human being. (...) Euthanasia is an intrinsically evil act, whatever the occasion or circumstance."

We refer back to canon law – legislation formulated by the Church. It equates life itself as an "inalienable value" and the intention to end it – beyond the motivation that drives the person to consider such a course of action – is absolutely deplorable and therefore, the person is who resorts to euthanasia or assisted suicide is denied the funeral rite.

Although there are now several countries attempting to regulate "good death," none – or almost none – of them do so as a matter of eugenics. Eugenics "indicates a set of theories and practices aimed at improving the genetic quality of a certain population," which at this masks itself as totalitarianism. In the recent past, there were the Nazis who mass sterilized non-Aryan "races" and considered some to be inferior and bringers of life without value.

Getting back to the initial and key point of the question, which has many different aspects to it: Can dying be a free choice? How can a person believe they have a coherent and full perspective of it?

Suffering in itself, especially if it is intense, is an intimate, personal, and therefore very subjective experience. Quantifying an illness in theoretical terms is as impossible as trying to explain it in juridical terms. To "justify" the choice of an individual who wants to throw it away in such a drastic and compulsory way, is also a risk. How much rationale does a person have if constantly under the pressure of the suffering that led him to consider euthanasia? How reasonable must a person or institution be who allows such a thing to happen?

The moral condemnation posed by the Church in the letter Samaritanus Bonus makes sense: it is condemnable to not strive to provide sick people with proper care, support, and dignity.

As people, we should perhaps only follow the “proper” or “right” path because life is sacred and unique, and fighting for it is an undeniable right. However, we also have a duty to do everything possible to ensure that man's right is not altered by outside causes.

As Professor Marcos Gómez Sancho says, let's first give everyone in the world the possibility to be treated and move forward with palliative care. These, accompanied by the love and warmth of doctors, friends, and above all family, can ensure that a patient is, at the very least, indecisive – reflective – since they would not be mired in all sorts of pain.

Euthanasia should not be a consequence of medical and social failure; it should not be the only feasible solution for the sick person because he or she is led down an endless physical and mental decline. It should not be "forced" to be considered because palliative solutions don’t seem sufficient.

As stated before: there is a right to life – to live a life of dignity.

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