European Convention on Human Rights again at center of fight for freedom to kill

Ordo Iuris

The case before a Dutch court concerned euthanasia, specifically the freedom to access so-called assisted suicide. In a December 14 ruling, the district court in The Hague ruled that the legality of assisted suicide will remain limited in the Netherlands to situations in which it is performed by a doctor while adhering to the rules set forth in the law. Thus, the Dutch court disregarded the position of the party bringing the case, namely an organization lobbying for the expansion of access to assisted suicide, demanding the removal of the requirement for a doctor to participate in the procedure. However, the problem of euthanasia is not exclusive to the Netherlands or even more broadly to Europe. Canada in particular is currently grappling with the dire consequences of its legalization. 

Euthanasia and the law

In mid-October, the Ordo Iuris Institute published a cross-sectional report on euthanasia in European countries. In this publication, based on numerous examples, we showed what the legalization of killing a person at his request leads to. Initially, it involves a small number of cases of diseases in which the patient can successfully request the shortening of life, to grow over time into an efficient "machine" for the elimination of the weak, requiring constant medical care, suffering from abandonment by loved ones. A few months ago, the Institute reported that the European Court of Human Rights ruled on a euthanasia case carried out on a 64-year-old Belgian woman who formally requested a lethal injection in 2012 due to "unbearable mental suffering." The suffering was caused by depression, exacerbated by the death of her husband, and relationship problems with her two adult children. It is worth mentioning that Belgium is one of those few countries where the law allows euthanasia for people suffering from depression, even if they are perfectly healthy physically. Since the law gives permission for this kind of solution, the woman was allowed to be euthanized instead of proper therapy and psychological help. It is difficult to assess this situation other than as a devastating failure of the 21st century health care system....  

Dutch 'no' on assisted suicide

Along with Belgium, the Netherlands is a country where the law provides for broad access to euthanasia, including so-called assisted suicide, a situation in which a person requesting a shortened life takes a death-causing agent obtained from a doctor. According to the official government website, in the Netherlands, according to the law, euthanasia is performed by the attending physician by administering to the patient (at the patient's express request) a lethal dose of the appropriate drug. Relevant Dutch legislation also covers physician-assisted suicide - that is, situations in which the doctor provides the drug, but the patient takes it himself. In other cases, assisted suicide is illegal, meaning that the person helping the patient cannot be, for example, a family member or friend who is not a doctor. The euthanasia lobbying organization Cooperative Last Will recently demanded a change in this regard before a court in The Hague, arguing that "the ban on assisted suicide without medical supervision violates the right to self-determination and respect for private life, as enshrined in the European Convention on Human Rights." The Hague court, however, found that, derived from the Convention's provisions, "the right to self-determination does not extend so far as to include the right to obtain assisted suicide." What is noteworthy, however, is that while the Dutch court opposed expanding access to assisted suicide, it nevertheless supported the position that "the right to decide for oneself the end of one's own life is indeed protected" by the Convention.

Consent to euthanasia - and what next?

The case decided by the court in The Hague once again shows that the legalization of euthanasia is only a starting point for pressure that a country, which - by renouncing the criminalization of this procedure - has already opened such a gate, should introduce ever more far-reaching concessions in this regard. The best example here is Canada, where euthanasia (including assisted suicide) was legalized in 2016. Initially, the option to shorten a patient's life was available in that country for terminally ill patients. In 2021, the permissibility of euthanasia was extended to a group of patients for whom natural death is not believed to be imminent. This group includes, for example, a group of people with long-term disabilities, who under the new law can request medical assistance in dying.

However, this aforementioned "freedom" in deciding one's own life has a second face - at the beginning of December 2022, news circulated in the media that a disabled veteran in Canada, a former Paralympian, was offered euthanasia by a social worker after she complained about the length of time she was waiting for a wheelchair elevator to be installed in her home. After the offer made to the disabled woman was revealed, it became clear that this case was not an exception, and that other veterans had also received similar "offers" from social workers. Looking at the direction in which the realization of the right, recognized in the jurisprudence of some countries, to decide the moment of one's own death is heading, one gets the impression that this "right" is beginning to transform into an obligation on the part of the patient to meet the expectations of third parties, such as the state bearing the expenses of caring for the disabled or terminally ill.       

Canada halts further facilitation of killing

The publicity surrounding the Canadian veteran's case seems to be paying its first dividends. Last week, Canada's justice minister announced that the country would delay a law that would allow people with mental illnesses access to medically assisted death. The reason for holding off on further concessions to expand access to euthanasia is the concern of some clinicians that the health care system is not equipped to handle complex cases. Arguments of protecting vulnerable patients and respecting individual autonomy have also entered the debate. In March 2023. Canada was to become one of the few countries in the world where medically assisted suicide for chronic mental disorders would be legal. 

Katarzyna Gęsiak - director of the Ordo Iuris Center for Medical Law and Bioethics