Legalization of Euthanasia in Portugal: The Impact on European Countries and the Role of Pope Francis

2023-10-01 07:53:18

Portugal is the latest country to have legalized euthanasia in Europe, joining Belgium, the Netherlands and Spain. In France, a bill on this theme was to be debated this fall in Parliament, before being postponed until 2024, as indicated by the Elysée. The Pope’s recent visit to Marseille would have had a lot to do with it.

Pope Francis was in Marseille on September 22 and 23. If his visit to France’s second city was mainly devoted to the Mediterranean and the migratory challenge, the sovereign pontiff also indirectly mentioned the law expected soon in France on this theme, warning once morest the “perspective falsely worthy of a death gentle”.

We don’t play with life! We don’t play with life, neither at the beginning nor at the end

Pope Francis upon his return from Marseille on September 23, 2023.

“Who listens to the groans of isolated elderly people who, instead of being valued, are parked in the falsely dignified perspective of a sweet death, in reality saltier than the waters of the sea?” the Pope asked , known for being uncompromising on the issue of end of life.

“We don’t play with life! We don’t play with life, neither at the beginning nor at the end,” he then added on the plane which took him back to Rome. “Today, let us be attentive to ideological colonizations which go once morest human life. Otherwise, it will end with this policy of no pain” which he described as “humanist euthanasia”.

>> Read also: Pope Francis arrived in Marseille as part of a visit focused on migration

Pope Francis was in Marseille (F) on September 22 and 23. [Sebastien NOGIER – afp]

While the debate in the French Parliament on the issue was announced for this fall, the Minister of Relations with Parliament Franck Riester indicated Monday that it should ultimately take place “next year”, with a presentation to the Council of Ministers “before the end of the year” according to him.

Does the Pope’s visit to the Phoenician city have anything to do with it? Nobody knows. But one thing is certain, it is that the draft bill on the end of life, which should open access to active assistance in dying in France, is on Emmanuel Macron’s desk. A project that he would still like to make the societal marker of his last five-year term. But personal questions and political considerations would torment the French president, even if he would still like to maintain his objective.

“President [est] a little reserved [sur le sujet], confided a minister, in mid-September, to Agence France-Presse. When he has reservations regarding something, he waits as late as possible to decide.”

The situation in Europe

Euthanasia and assisted suicide are today authorized in a handful of European countries. The Netherlands and Belgium were the first two European countries to authorize euthanasia, namely death caused by a caregiver at the request of a patient. Although it does not authorize euthanasia, Switzerland has nevertheless allowed assisted suicide for almost a century, making it a pioneer on the issue (read box).

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The President of Portugal, the conservative Marcelo Rebelo de Sousa, promulgated the law decriminalizing euthanasia in mid-May. [Tiago Petinga – keystone]Portugal is the last country to have authorized active euthanasia. The Portuguese president, the conservative and practicing Catholic Marcelo Rebelo de Sousa, promulgated a law to this effect in mid-May adopted shortly before by the Socialist-majority Parliament, at the end of a laborious legislative process.

>> Read also: Portuguese Parliament adopts law to decriminalize euthanasia

“The Constitution obliges the President to promulgate a law which he vetoed and which was confirmed by the Assembly of the Republic. I will promulgate it, of course, it is my constitutional duty”, indicated following the vote Marcelo Rebelo de Sousa even though he had vetoed it several times.

The final version of the law provides that euthanasia is only authorized in cases where “medically assisted suicide is impossible due to the physical incapacity of the patient”.

Its entry into force scheduled for this fall will certainly not end the public debate on this divisive subject in a country with a strong Catholic tradition.

In the Netherlands, active euthanasia and assisted suicide are permitted. It has been strictly regulated since 2002. According to Dutch law, the doctor and an independent expert must determine that the patient is suffering intolerably and without hope of improvement. It must also be established that the request for euthanasia is carefully considered, voluntary, and that there is no other “realistic option”.

After years of debate, end-of-life assistance was extended in April 2023 to children under 12 who suffer from incurable illnesses leading to inevitable imminent death.

Every year in this country, more and more people resort to euthanasia. In 2022, 8,700 people used it, according to official figures. The majority suffered from terminal cancer.

In Belgium, euthanasia and assisted suicide are also authorized. The request must be “voluntary, thoughtful, repeated” and “without external pressure”, according to a text promulgated in 2002. The doctor must also ensure that the patient has the capacity for discernment and that he suffers from a serious and incurable pathology.

In 2014, Belgium became the first country in the world to authorize euthanasia for minors with no age limit.

>> Read also: Belgium adopts a law extending euthanasia to minors

In Luxembourg, euthanasia and assisted suicide are legal, namely when the patient himself takes a prescribed product to cause death. “The fact by a doctor of responding to a request for euthanasia or assisted suicide is not criminally sanctioned and cannot give rise to a civil action for damages”, according to the Luxembourg law promulgated in 2009. Euthanasia is only possible for adults in a hopeless medical situation.

Spain also adopted a law in March 2021 that allows euthanasia and medically assisted suicide.

Spanish law provides that any person with “a serious and incurable illness” or “chronic pain placing them in a situation of incapacity” can request help from the medical profession to die and thus avoid “intolerable suffering”. Strict conditions govern the process, which must notably receive the green light from an evaluation commission. The patient must also be of legal age, have Spanish nationality or have resided in Spain for more than 12 months.

>> Read also: Spain becomes fourth EU country to authorize euthanasia

Switzerland has authorized assisted suicide for many years. From 1893 to 1918, Swiss lawmakers debated recognizing the right to assisted suicide as an act of personal freedom, while punishing assistance for selfish motives. The Federal Council, in its development of the Penal Code in 1918, already mentioned the terms of article 115 CP which was put into force on January 1, 1941 and has remained almost unchanged until today.

>> Read also: Increase in the number of suicides accompanied by Exit in 2022

The practice of assisted suicide is regulated by codes of medical ethics and is generally supported by organizations such as the Exit association, which supported 1,627 people in the death process in 2022.

Please note, however, that direct active euthanasia remains prohibited in Switzerland.

>> Watch the 7:30 p.m. report on 40 years of Exit (June 11, 2022):

The Exit association, which supports assisted suicide, celebrates its 40th anniversary / 7:30 p.m. / 3 min. / June 11, 2022

Austria legalized, by a vote of Parliament in December 2021, assisted suicide for people suffering from a serious or incurable illness. This law came into force on January 1, 2022.

Just like in Switzerland, euthanasia is however prohibited.

In Italy, the Constitutional Court de facto decriminalized assisted suicide in September 2019 for certain cases: for fully conscious patients “kept alive by treatments (…) and suffering from an irreversible pathology, a source of physical and psychological which they consider intolerable”.

But active euthanasia remains considered a crime.

>> Read also: Assisted suicide authorized for the first time in Italy

Situation still unclear elsewhere

Without going as far as active euthanasia or assisted suicide, several European countries authorize certain forms of assistance in dying.

>> Read also: French quadriplegic patient Vincent Lambert has died

For more than six years, several court decisions suspended and then validated the cessation of treatment without the patient’s condition improving. Eight and a half days following stopping his treatments and the food that kept him alive, Vincent Lambert died on July 11, 2019, more than 10 years following his accident.

Note that the legislation might soon evolve towards a “French model of the end of life”, according to President Emmanuel Macron who announced a bill at the beginning of April following the organization of a citizens’ convention which was decided by a large majority for the establishment of “active assistance in dying”. Parliament is expected to debate the issue in the coming months.

>> Read also: In France, a Citizens’ Convention says “yes but” to assisted suicide

In Germany, passive euthanasia is tolerated if the patient requests it. In February 2020, the Constitutional Court also censored a 2015 law prohibiting assisted suicide by doctors or associations.

>> Read also: Germans have the “right to choose their death”, according to the Constitutional Court

In the United Kingdom, since 2002, interruption of care in certain cases has been authorized. However, assisted suicide remains punishable by up to 14 years in prison. But new guidelines issued in 2010 encourage leniency when the act is carried out out of “compassion”.

Fabien Grenon with the agencies

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