Assisted suicide has been legal in Spain since June 2021
Credit: Shutterstock: Megaflopp
While probably not the most palatable of subjects, assisted suicide has recently become a hot topic of conversation in the UK.
You may have seen, for example, that broadcaster Dame Esther Rantzen has been championing for members of parliament (MPs) to attend an assisted dying debate. This follows more than 200,000 people signing a petition calling for dying people to be able to ask for medical assistance to end their lives with dignity.
Dame Rantzen, herself terminally ill with lung cancer, revealed last year that she had joined Dignitas, the assisted dying clinic in Switzerland. Naturally, she would much prefer to remain in the UK, and as she explained, “A change in the law would mean that I could look forward in confidence to a death which is pain-free surrounded by people I love.”
Spain legalised assisted suicide in 2021
Thankfully, residents in Spain do not have to resort to such measures, as Spain is one of seven European countries to legalise assisted suicide, with Austria, Belgium, Luxembourg, The Netherlands, Portugal and Switzerland being the other six.
Interestingly, of those seven, only five have also legalised euthanasia, with the act remaining illegal in both Austria and Switzerland.
Therefore, it is essential to understand the difference between the two as they are often thought to be one and the same thing. To explain:
Assisted Suicide is the act of intentionally helping another person to end their life, for example, handing them pills knowing their intentions. That person can be terminally ill or enduring insufferable levels of pain.
Euthanasia, on the other hand, is the act of deliberately ending a person’s life to relieve suffering in which a physician administers a lethal drug. Again, they do not necessarily need to be terminally ill.
The law in Spain legalising euthanasia (incorporating assisted suicide) came into force on June 25 2021. This was a significant change as prior to that, helping somebody die in Spain was potentially punishable by a jail term of up to 10 years.
Turning to X just minutes after the vote, Spanish Prime Minister Pedro Sanchez tweeted, “Today we have become a country that is more humane, fairer and freer. The euthanasia law, widely demanded by society, has finally become a reality.”
Report identifies impact of assisted suicide law in Spain
However, discussing this issue with a local funeral planning company highlighted that perhaps the change in law had not been widely publicised enough. Aside from not having dealt with any discussions or requests of this nature, there appeared to be some confusion as to whether it was only applicable in Andalucia.
Perhaps this stemmed from a decision made by the regional government In March 2007 when they agreed to a 51-year-old woman’s request to have a respirator turned off, which was keeping her alive.
Nevertheless, the first official report released in mid-February 2022 by the Spanish Ministry of Health identified 173 requests had been made between the law s entry into force and the end of 2021. Of those, 75 were actually carried out, demonstrating the new law s early-stage impact on Spanish society.
Euthanasia preferred over assisted suicide in Spain
All 75 were carried out using euthanasia processes as opposed to the option of assisted suicide. As recommended by the Spanish Ministry of Health Good Practices Manual, intravenous injections of a coma-inducing drug (propofol) and neuromuscular blockers (atracurium, cisatracurium or rocuronium) preceded by adjuvant premedication (midazolam and lidocaine) were administered.
Of those denied, several reasons were cited, including death while the request was being processed, withdrawal, postponement, and flat-out rejection of the request. It would seem, then, that, as might be expected with such a complex matter, the process for gaining agreement to a euthanasia request is not a simple one.
Process for requesting assisted suicide or euthanasia in Spain
As explained, the Spanish Law permits two voluntary means of allowing a person to end their own life: euthanasia and assisted suicide. To request either, the law states that the person must first be an adult Spanish national or a legal resident.
Providing they meet that criteria, they must also be suffering a ‘serious or incurable illness’ or a ‘chronic or incapacitating’ condition that causes ‘intolerable suffering’ and
When they make the request, they must be ‘fully aware and conscious’, and it must be in writing with a medical healthcare professional present. The patient and the medical practitioner sign and date the document.
Following such a request, the doctor will assess the individual against the criteria, and if in agreement, a second instruction will need to be presented a minimum of 15 days later. This time, another consulting doctor must make a further assessment, and they, too, must agree that the criteria have been met.
The final stage is for the case to be submitted to an Evaluation Committee of legal and medical personnel who will decide if approval is granted.
The entire process from submitting the first request is estimated to take approximately 45 to 50 days, and a patient can withdraw at any point.
Conversely, given the sensitive nature and potential moral dilemma associated with such a request, a doctor can withdraw from participating in the procedure on the grounds of ‘conscience’.
Over to you – Do you think that more countries should be legalising euthanasia and assisted suicide?
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