Euthanasia

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.

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On May 19, 2022, the Federation of Swiss Doctors (FMH) reviewed its directives concerning the support of people at the end of life and has revised its guidelines to follow those applied by the Swiss Academy of Medical Sciences (ASSM) since 2018. The new text explicitly states what was implicit until now: assisted suicide of healthy people is not defensible from a medico-ethical point of view. Unbearable suffering must be proven. Doctors must also now be more involved by conducting at least two interviews with people wishing to resort to assisted suicide. Suicide assistance organizations deplore much more complicated access to assistance and fear that assisted suicide will become much more difficult.

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Theo Boer was invited by the NGO Prudencia Uruguay to give a lecture in Parliament as the euthanasia project is being studied in the Chamber of Deputies. He worked almost ten years reviewing cases of euthanasia practiced in the Netherlands. In total, about 4,000 cases passed through his hands in that decade. While he agrees that assisted suicide should be practiced in some cases of terminally ill patients, the Dutch experience led him to change his mind and advises looking at the figures and what happened in his country so as not to repeat that experience. His position turned against the lev because the euthanasia numbers have quadrupled and the laxity with which the criterion of intolerable suffering is used.

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Since 2003 Korea has experienced the highest suicide rate among OECD countries. One of the societal risk factors that triggers suicide is the contagious nature of suicide. The number of public suicides soars after media reports on celebrity suicides (increased by 16.4% within just one day after the reports) while celebrity deaths by accidents or diseases have no effect on the public suicide. Further analysis reveals that female and younger subgroups are more likely to be affected by celebrity suicides. Moreover, the public reacts more strongly to suicide incidents of celebrities of the same gender and even imitates the methods of suicide used by celebrities. It highlights the significance of responsible media coverage of suicide stories to prevent copycat suicide.

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Posner argued: People who have no immediate wish to die by suicide get reassurance from knowing that they can exercise the option of suicide at some point in the future. The study used data from ten US states that implemented an assisted suicide law up to the end of 2019. Assisted suicide laws increase total suicide rates by about 18% overall and 40% for women and unassisted suicides about a 6% increase overall, 13% increase for women. One interpretation that women are more affected is that the higher take-up of assisted suicide reflects women being empowered to take control over end-of-life decisions. The other is the disempowerment of those who are more vulnerable to social pressure to die by suicide.

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Assisted suicide has been rejected in Connecticut for the tenth time, after a close vote by senators on the State General Assembly’s judiciary committee. The disability rights group Second Thoughts Connecticut and The Euthanasia Prevention Coalition USA strongly opposed the plans. They warned “offering suicide prevention to most people while offering suicide assistance to an ever-widening subset of disabled people is lethal disability discrimination”.

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Palliative care doctor Suzanne Walter and her patient Diethelm Harck started a court case to legalise euthanasia in South Africa. Walter was diagnosed with multiple myeloma in 2017, while Harck was diagnosed with motor neuron disease in 2013. Both wish to end their lives when they feel they cannot handle their illnesses any more. Due to their medical conditions, special arrangements were made in March for the evidence of Harck and Walter to be heard first via a commission headed by Judge Neels Claassen. Their application for an order directing the government to enact legislation which will allow for physician-assisted suicide and euthanasia, is due to proceed in the South Gauteng High Court for six weeks from May 3.

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The ECHR points out in a judgment opposing a Danish euthanasia activist, Mr. Lings, to the justice of his country that the European Convention on Human Rights man “does not enshrine the right to assisted suicide”. Svend Lings, an activist doctor, was sentenced in September 2018 for having prescribed lethal products to two people who wanted to commit suicide. He claimed to be the victim of a violation of Article 10 of the European Convention on Human Rights relating to freedom of expression. The judges of the ECHR considered that freedom of expression was not in question. The Court further held that the Danish state indeed had a duty to protect the most vulnerable members of society.

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On March 28, 2022, Oregon Attorney General Ellen Rosenblum entered into a settlement agreement that guaranteed the non-enforcement of the residency requirement in Oregon’s “Death with Dignity Act.” This statute limited physician-assisted suicide access to residents of Oregon. Oregon Right to Life Executive Director, Lois Anderson, warns against the short physician-patient relationships and the push to eliminate any waiting period for life-ending drugs. He says that the residency requirement at least protected some patients from predatory practices going unnoticed in the current execution of the law. “Oregon has launched its new industry—death tourism.”

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Natural law is not a physical law or a law that man has imposed on himself. It is a universal moral law, intrinsic to man, instilled in his conscience. We have all heard children exclaim “that’s not fair!” or shared similar emotions over international events. These experiences show the commonality of an awareness of good and evil. This allows us to conclude two things: Human life is sacred; all men have a common destiny and a common law instilled in their consciences. If human life is sacred, then anything that protects, for example the prohibition of murder; is good. The idea that there is no objective law is a disastrous manifestation of the current postmodern relativism.

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