Although euthanasia might at times be in the patient's best interest, it could end up encouraging a "culture of death" within society, a consultant oncologist told parliament. 

During a joint meeting of the House Social Affairs, Health, and Family Affairs Committees held on Wednesday, Dr Brincat said that, in cases where patients were not capable of making their own decisions, some relatives even refused to bring people requiring treatment to hospital. When patients incapable of exercising medical autonomy were being cared for by doctors, the latter might face situations where relatives requested euthanasia or the withdrawal of treatment for ulterior motives.

Health Minister Chris Fearne said that, for this reason, it was important to clarify legislation relating to the responsibilities of healthcare professionals and the medical autonomy of patients.

Some relatives even refused to bring people requiring treatment to hospital

Experts took great pains to differentiate between euthanasia and the withdrawal of treatment. While the latter may involve a living will, instructions preventing resuscitation, or the token extension of life, the former involved an active attempt to end the patient’s life. Ultimately, although it was the medical professional’s duty to attempt to treat the patient to their best interest, it was up to the patients themselves to decide whether they wanted to accept treatment or not, with doctors obliged to respect their decision.

Consultant Dr Doreen Pace said that palliative care sought to respect the lives of patients as holistically as possible, considering death to be a natural process. She said patients with terminal illnesses who had corresponded with her said they “want[ed] to have the choice to die,” and “[they don’t] want to be a burden on anyone.”

She noted that the responsibility to care, whether for the very young or very old, was increasingly being shifted from the family to the State, and that a natural consequence of ageing was being conceived of as a burden. Natural dependency need not lead to loss of dignity, she said.

Oncologist Dr Nick Refalo said that he didn’t know whether he would be ready to perform euthanasia if a patient asked it of him. Ultimately, the decision of whether or not to assist a patient to end his life was extremely subjective, as were all medical decisions, but he thought he would draw the line there.

While a shortened life as the result of palliative measures or the withdrawal of treatment was not necessarily a bad thing in palliative care, in the case of an active hastening of a patient’s death it was hard to evaluate whether that patient truly wanted to die.