In sickness and in health
Recently, our country has seen an increased willingness to discuss the controversial topic of euthanasia. This willingness is very welcome, as it presents a wonderful opportunity to celebrate human dignity, which contrary to the beliefs of some, does not depend on one’s state of health.
Like marriage, in which institute the spouses promise to love and respect one another in sickness and in health, so does human dignity remain equally intact in sickness as well as in health.
The word euthanasia comes from the Greek word eu, meaning good and the word thanatos, meaning death. Thus, from an etymological perspective, “euthanasia” means “good death”. This begs the question as to what a good death entails. In view of the fact that euthanasia is almost always invoked in cases of illness, it might prove wiser to examine the natural human urge to love and to live and thus to spare no effort in combating all manner of threats against one’s life.
Euthanasia is diversely framed. They include “dying with dignity”, “helping someone to die” and “an act of love towards someone whose suffering is unbearable”. Euth-anasia needs to be objectively examined.
What is dignity? If and when one says that euthanasia is simply the act of ensuring that one dies in a dignified manner, perhaps one is implying that all those who do not choose to be euthanised die in an undignified manner. The inherent human dignity of all human beings is recognised by all human rights instruments, which cite inviolable human dignity as the basis for human rights.
As an example, one may take Article 2 of the European Convention on Human Rights, which states no one may be intentionally deprived of his life. Therefore, to allow euthanasia is to allow the violation of this most basic of human rights. This was confirmed by Resolution 1859 (2012) of the Council of Europe. Case law of the European Court of Human Rights has also repeatedly confirmed Article 2 as the fountain of all human rights.
Death with dignity does not entail allowing euthanasia. On the contrary, it entails investment and training in palliative care, pain management and the provision of psychological assistance when necessary.
Another frame in which euthanasia is presented is that of “helping someone to die”. In order to dismantle this, one must question what is meant by ‘help’. It is a contradiction in terms to place the words ‘help’ and ‘die’ in the same sentence. When one requests help, one is asking for relief from hardship and not for death.
As its name implies, the World Medical Association is composed of physicians, whose job it is to heal the sick, has consistently stated that euthanasia, which is described as the act of intentionally ending the patient’s life is deeply unethical, whether carried out at the patient’s own request or of his family.
From the 38th World Medical Assembly in 1987 to similar gatherings in 1992, 2002, 2005 and as recently as 2013, this has been consistently reaffirmed. The World Medical Association has strongly urged national medical associations and all physicians to refrain from participating in euthanasia.
True help rendered by the medical professions stems from the Hippocratic oath, according to which, doctors swear to do no harm. Needless to say, to bring about death is the worst form of harm. Euthanasia tells a person that it is better if they were not alive and that palliative care, pain management and psychological assistance in their regard is a waste of money and resources.
When euthanasia is framed as an act of love, one must question the notion of love. Genuine love is already a herculean (but but impossible) enterprise. Loving someone in times of sickness is even more so. But love does not entail the bringing about of death.
Loving someone means being at one’s side and helping to provide the best possible care. Love does not say that it is better if the sick person were not alive. Many organisations which are bastions of solidarity and support would certainly not exist if euthanasia were possible in Malta.
Instead of offering euthanasia, governments should be investing in pain management and palliative care. The sick, even those terminally so, need to be surrounded by their loved ones and by accessible psychological support. Is it any wonder that a person requests euthanasia if he is cut off from any emotional support whatsoever?
To combat this, one must ensure that people remain connected to their neighbourhoods and communities. Euthanasia kills off the natural human instinct of solidarity with those who are suffering. It quickly becomes more convenient to pressure the vulnerable into opting for euthanasia rather than providing effective care and support.
The sick do not need to be disposed of. They need to be helped to get better. In cases of terminal illness, these persons who in the course of their lives certainly contributed much to society need to be loved and supported by that same society. As a society, let us love one another, in sickness as well as in health.
Ramon Bonett Sladden and Sara Portelli are lawyers and members of Life Network Malta.