Turning death into a medical treatment

Spain and Portugal are moving towards legalising euthanasia. They should think again.

Kevin Yuill

Topics Politics World

Spain and Portugal have both moved closer to legalising euthanasia (in which a physician actively brings about a patient’s death) and assisted dying (in which a physician provides the lethal means for a patient’s death).

Earlier this month, the Spanish parliament passed a draft bill – supported by Spain’s Socialist government, the left-wing Unidas Podemos and the centre-right Ciudadanos – that will allow euthanasia and assisted dying in certain cases. And then, last week, the Portuguese parliament followed suit, and voted through several bills proposed by the ruling Socialist Party. These will legalise euthanasia and assisted dying for terminally ill people.

There is still some way to go before these bills become law. In Spain, the prospective legislation will now be scrutinised by a parliamentary health committee, before heading to the Senate, and then back to the lower house for a final vote. And in Portugal, the parliament’s decision could still be vetoed by Portugal’s conservative president, Marcelo Rebelo de Sousa. Although parliament could then override his decision if it wanted to.

Nevertheless, these represent significant steps towards the legalisation of euthanasia and assisted dying in both nations. If the Spanish and Portuguese governments are successful, they will become the fourth and fifth countries in Europe to legalise euthansia, following the Netherlands, Belgium and Luxembourg.

It should be noted that Spain’s and Portugal’s respective bills are not identical. The Spanish draft bill follows the example of the Netherlands, Belgium and Luxembourg, and mandates euthanasia or assisted dying as an option for someone whose life has become ‘unbearable’, due to a serious and incurable illness or a chronic, severe disability. His or her doctor would then have to agree with the patient to take this course, and obtain a second opinion from a colleague outside his team. After two weeks, the patient must repeat the initial request, which is then forwarded to a committee for assessment.

The Portuguese proposal, which comprises five separate bills, is still to be pulled together into a single bill. This makes it difficult to tell at this stage what precisely the legislation will entail.

What makes the respective developments in Portugal and Spain particularly significant is that, unlike the other European countries in which the right to die has been enshrined in law, these are historically Catholic countries. They have therefore long been dominated by traditional Catholic mores.

The move to legalise euthanasia and assisted dying can be seen, therefore, as part of a broader attempt to continue to shake off the shackles of Catholicism and embrace a more socially liberal future. In this respect, legalising euthanasia and assisted dying follows moves over the past two decades to legalise abortion and gay marriage. It is seen as an opportunity for these two recently elected Socialist governments to flex their liberalising muscles, just as their predecessors did, and move towards a post-Catholic future.

But while the legalisation of abortion, for example, ought to be celebrated as a victory for women’s reproductive rights and individual freedom, there are good reasons why we ought to resist the move to legalise euthanasia and assisted dying.

Most obviously, legalising euthanasia and assisted dying can occasionally put pressure on individuals to opt for an early death. But there is a more fundamental problem. Legalising euthanasia and assisted dying creates a culture in which death is presented as a form of medical treatment. There is, of course, always talk of safeguards, of strict conditions that have to be met before allowing someone to be euthanised or to request assistance to die. But such safeguards are always breached, and the strict conditions are always relaxed.

We know this because it has already happened in those countries that have legalised assisted dying and euthanasia. In Belgium and the Netherlands doctors now routinely end the lives of patients suffering from psychiatric illness, with no underlying physical illness. In Belgium, for example, 38-year-old Tine Nys was euthanised by doctors in 2010. Her psychiatric condition consisted of no more than a recent diagnosis of Asperger’s Syndrome. Her family, who have now taken the doctors to court, argue that Nys’s reason for seeking to end her life was no more than a failed relationship. They argue that that falls far short of the threshold of a ‘serious and incurable disorder’ required under Belgian law.

Or take the ‘coffee euthanasia’ case in the Netherlands. It was revealed during a court case last year that a doctor slipped a sedative into the coffee of her patient, who had Alzheimer’s. She then attempted to administer a lethal drug, but her patient resisted, so the doctor enlisted the help of the patient’s family, who held the patient down while the doctor eventually managed to euthanise her. The doctor was cleared of unlawful killing on the grounds that the patient had consented to be euthanised, rather than be put in a care home, in a statement written four years before her death.

Unsurprisingly, Dutch medical professionals are growing uneasy about the the extent to which euthanasia is used, in cases like the above, for those who are unable to consent. Medical ethicist Berna Van Baarsen recently resigned from a Dutch regional review board responsible for overseeing euthanasia. She criticised the growing frequency with which dementia sufferers are being euthanised on the basis of a written directive they are later unable to confirm orally after losing their faculties.

Theo Boer, a medical ethicist at the University of Groningen, has even issued a warning to those nations considering legalisaing euthanasia and assisted dying: ‘Look closely at the Netherlands because this is where your country may be 20 years from now.’

Examples from outside Europe are also instructive. Canada legalised assisted suicide and euthanasia in 2016 after a woman in the advanced stages of motor-neurone disease took her plea to be euthanised to the Supreme Court, which ruled in her favour. Since then, the conditions that have to be met for someone to be euthanised, or to request assistance to die, have been consistently relaxed. The province of Quebec, for example, struck down the federal requirement that natural death be ‘reasonably foreseeable’ – that is, imminent. And Canada’s justice minister, David Lametti, has already signalled that he intends to expand the right to die to people suffering from psychological conditions or mental illness.

Again and again a nation enshrines the right to die, stating that it is only to be exercised under strict conditions, and again and again those conditions are relaxed. Death soon starts to appear as an all-too-acceptable solution to all sorts of medical conditions and, just as worryingly, emotional situations.

Some in Spain and Portugal might feel that legalising euthanasia and assisted dying indicates the extent to which they have embraced a new era of post-Catholic freedom. But the right to die is not an expression of freedom. It is an expression of nihilism. It captures a growing sense that, for some, there is nothing left to live for.

Of course, there are occasionally cases where killing for compassionate reasons is the right thing to do – there is, as Lord Sumption puts it, no need to change the law, but the infrequent need to break the existing one. But the quest to legalise euthanasia, rather than addressing a burning need, merely expresses a deep cultural pessimism. We should resist it.

Kevin Yuill teaches American studies at the University of Sunderland. His book, Assisted Suicide: The Liberal, Humanist Case Against Legalisation, is published by Palgrave Macmillan. (Buy this book from Amazon (UK).)

Picture by: Getty.

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2nd March 2020 at 3:34 am

Euthanasia is the logical outcome of an atheistic society.

Elizabeth Smith

29th February 2020 at 7:56 am

A person with decision making capacity should have the choice.
Many of those suffering terminal dementia would most emphatically not have wished to be kept alive to reach that condition and because of the practical, logistical issues surrounding Dignitas, ie you have to be able to make your own arrangements and travel there unassisted, those who seek them out usually have maybe 3-6 months or more of acceptable life left to them. Why should the religious beliefs of X, which Y does not share, compel Y to continue to eke out an utterly unacceptable existence, which can be for purely socio economic reasons.
Let a capacitous person have legal access to the means to end their life, please! The fear of surviving, severely disabled, is the deterrent to seeking street drugs and so forth. These days disability and the care system is more to be feared.
We don’t see, whether in the media or the Courts, the cases where there is consensus. Those where professionals and family concur that there should be no officious striving to keep this person alive. As for the cases involving severely disabled neonates where the parents want them to be allowed to slip away and some religious idiot disagrees, I suspect parental responsibility is surrendered to the State and the parents walk away.

Michael M

26th February 2020 at 9:18 pm

New Zealand is voting on euthanasia at a referendum this September. The civilised veneer over barbarism has never been this thin.

Stef Steer

26th February 2020 at 9:06 pm

Wow the cases you cite above in Belgium and Holland are truly horrific and frankly not far removed from Nazi Germany killing people because they are (even if consensually) unwanted. Europe seems to be headed in a very ugly direction and it ain’t the fringes that are pushing it there its the increasingly less liberal hand wringing just coming from a place of compassion orthodoxy.

Joyful Cynic

26th February 2020 at 7:27 pm

Legal euthanasia and assisted suicide are not about the “right to die” – we already have that as suicide is legal. It is about getting societal approval and abdicating a portion of the responsibility for the action to another. The usual argument made is for assistance if/when an individual becomes totally physically unable to take their own life without assistance – but such cases where this is genuinely the case are extremely remote and rare and no law in the world has yet even started at that point yet alone remained at it.
As for dementia, so often people believe that IF something happens they would not want to live – only to find that if/when it does happen actually they do – many people who suffer disabling injuries find this, yes life is hard but they still want to live. Great if they can express their change of mind horrific if they cant. How many people say “if I ever end up in a wheelchair I would not want to live”? then find they can manage. What if doctors went and euthanased every person wo had previously said “if such and such happens”? (I am one of those people – not in a wheelchair but a chronic illness and I do not want to die). People may imagine if they get dementia they will want to die – but find if/when they get there they do not, only they can no longer express that and will be held to opinions made without the experience to understand.
If you wish to take your own life you are free to do so. Do not expect someone else to do the deed for you, and do not look for societal approval. Make your own decision and take responsibility for that yourself.

James Knight

26th February 2020 at 5:30 pm

It is far more insidious and subtle than suggested. Anyone can get depressed and lose the will to live if vulnerable and isolated, even if they have medical and practical support “to exist”. In some cases people don’t even have the practical support. “Helping” people to die when there is so much more that could and should be done to help people to live is criminal. It is a grotesque form of “nudging”.

Paul Duffin

26th February 2020 at 2:32 pm

“…legalisation of abortion, for example, ought to be celebrated as a victory for women’s reproductive rights and individual freedom, ..”

“Legalising euthanasia and assisted dying creates a culture in which death is presented as a form of medical treatment.”

I find these two positions to be at odds with one another. Both abortion and euthanasia/assisted dying treat ‘death’ as a form of medical treatment. In fact I find the latter morally more defensible (albeit still fundamentally wrong) than the former because are least in the latter case the intent is that the person doing the dying has actually consented to the ‘treatment’.

The author has a bad case of cognitive dissonance.

Jonathan Marshall

26th February 2020 at 5:49 pm

Well said.

Jerry Owen

26th February 2020 at 11:45 am

I have watched three people die of cancer, and my belief is that I do not want to suffer like they have, it is the cruelest form of death, I would rather have my life ended than suffer what i have seen.
However I still struggle with euthanasia and on balance would be against it.
Yes, I must be a hypocrite on this one!

Jerry Owen

26th February 2020 at 11:47 am

Giving the state more power over the individual has never resulted in good.

Nick Sanders

26th February 2020 at 10:57 am

I still value my personal freedom of choice above the small risk that some doctor might deliberately murder me. And for that matter: what other laws about the sanctity of life have ever prevented a malevolent physician to take lives?

Nick Sanders from The Netherlands

Linda Payne

26th February 2020 at 10:52 am

You can be sectioned against your will if you have a psychiatric illness, you can be forced drugs, get labelled and locked up. However when the person wants to die it seems they suddenly have full capacity and can be done away with, says a lot about Western society


26th February 2020 at 9:33 am

So the medical experts are advocating a culture of death are slowly changing hospitals into a veterinary?

Vadar’s Hate Child

26th February 2020 at 9:04 am

I don’t understand why abortion is seen as good, but euthanasia is bad. Both are the deliberate early ending of life.

Ven Oods

26th February 2020 at 9:15 am

The former doesn’t affect me, while that latter might, one day. But I share your unease at the celebration of abortion as ‘women’s reproductive rights and individual freedom’.
I’m reminded of the US comedian (name escapes me) who uses the line “if you can kill the little fuckers, surely I’m allowed to just abandon them?’

jessica christon

26th February 2020 at 6:07 pm

That was the brilliant Dave Chapelle.

Mike Stallard

26th February 2020 at 7:29 am

There is a story that King George VI was dispatched with a pillow so that his death could be announced on the 6 o’clock news!


26th February 2020 at 11:49 am

He did have incurable lung cancer.
Also, the story is true , why was it done when his heir, Elizabeth was on the other side of the world? A double bluff?


26th February 2020 at 11:49 am

IF the story is true

Elizabeth Smith

29th February 2020 at 7:43 am

You are thinking of George V. His doctor (Lord Dawson of Penn) gave him an overdose of painkillers.
George VI died in his sleep. It wasn’t expected just then.

Stephen J

26th February 2020 at 4:15 am

… and of course, one thing leads to another.

The next logical step to controlling death is to control birth.

Anyone for Eugenics?

Well socialists have been demonstrated to agree on many occasions, including the Webbs and G.B.Shaw.

However, from the manner in which this appears to be unravelling, it would seem this is an EU initiative like gay marriage, which suddenly becomes law everywhere, apparently independently by the 27/28.

It is globalism/communitarianism rather than socialism, and consequently even more dangerous. Expect the UK to be implementing it very soon.

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