Euthanasia and assisted suicide laws are still the exception, but lawmakers from New Zealand to Peru to Switzerland and beyond are gradually giving more space for people to choose to get help to end their lives — sometimes with new and innovative technological methods.
The announcement last month that a “suicide capsule” device would be commercialized in Switzerland, not surprisingly, caused quite a stir. The machine called Sarcophagus, or “Sarco” for short, consists of a 3D-printed pod mounted on a stand, which releases nitrogen and gradually reduces the oxygen level from 21% to 1%, causing the person inside to lose consciousness without pain or a sense of panic, and then die of hypoxia and hypocapnia (oxygen and carbon dioxide deprivation).
While active euthanasia is illegal in Switzerland, assisted suicide is allowed under certain conditions and under the supervision of a physician, who has first to review the patient’s capacity for discernment — a condition that Sarco aims to eliminate. “We want to remove any kind of psychiatric review from the process and allow the individual to control the method themselves,” Australian doctor Philip Nitschke, the machine’s creator, told news platform SwissInfo. Some argue that this is against the country’s medical ethical rules while others expressed concerns about safety.
But Nitschke says he found the solution: an online AI-based test, which will give a code to the patient to use the device if he passes.
It turned out that the machine, which is still a prototype, has not been approved by the Swiss government agency in charge of regulating medical products, but Nitschke believes he doesn’t need such approval under current Swiss legal guidelines and plans for a third prototype to be operational in Switzerland in early 2022.
Issues surrounding the right to die have been at the center of the debate in several countries particularly this past year — maybe as a result of the coronavirus pandemic and its numerous victims, which forced us to face our own mortality head on.
While euthanasia and assisted suicide are legal in just a handful of countries around the world, more are allowing the practice in certain conditions, or for specific cases.
New Zealand offers choice for terminal patients
Switzerland has legalized 3D-printed pods that allow people to end their lives
New Zealand is one of the latest countries which legalized euthanasia, following a referendum in 2020 with nearly 65% of voters supporting the End of Life Choice Act to become law. The legislation, which came into force in November 2021, includes conditions such as suffering from a terminal illness likely to end the person’s life within six months and being aged 18 or over, with certain steps to go through to ensure a person is eligible. The government also created a committee of three experts as a safeguard, to review reports of those undergoing the procedure.
the procedures are far from widespread and some are still hesitant to legalize them.
“New Zealand became a kinder, more compassionate and humane society for allowing people who are struggling and suffering in those last few days with their terminal illness choice and compassion on how and when they go,” said Brooke van Velden, the deputy leader of the ACT New Zealand party, which promoted the End of Life Choice Act.
Although he refused to disclose the number of assisted deaths since the Act took effect, the Ministry of Health told Stuff it was “fewer than 10,” estimating that up to 950 people could apply for assisted dying each year.
Medical aid in dying for Alzheimer’s and dementia
In Europe, Austria’s parliament has recently approved legislation to legalize assisted suicide for chronically or terminally ill people starting in January 2022, Deutsche Welle reports. The move followed a decision from a court that stipulated that the country’s criminal code ban of assisted suicide was unconstitutional and violated the individual's right to self-determination.
In Quebec, Canada, a government commission has released a report at the beginning of December 2021 that greenlights extending medical aid in dying for people suffering from a serious and incurable illness leading to incapacity, such as Alzheimer’s disease and dementia, La Presse reports. So far, Quebec’s 2014 “End-of-life care law” had only allowed people who are deemed apt to give consent to make a request for the procedure, excluding those who suffer from neurocognitive disorders.
High-profile cases in Italy and Peru pave the way
A rally for Spain's Right to Die with Dignity movement
In Italy, a country with deep Catholic roots, euthanasia has long been a controversial topic. The practice, condemned by the Church, is punishable by law with a sentence ranging from 5 to 12 years in prison. But this year, the case of a 43-year-old man identified as Mario, who was paralyzed in a traffic accident 10 years ago and asked doctors to end his life, has not only reopened the debate about the right to die in the country but also set an important precedent.
Last summer, Mario wrote an open letter to Health Minister Roberto Speranza, saying he wanted to “die with dignity,” La Stampa reports. A petition asking to reverse the law banning assisted suicide also collected more than 750,000 signatures. In November 2021, Italian authorities cleared the way for Mario to go through with assisted suicide — a historic first for the country, Corriere della Serra reports. An ethical committee ruled that Mario met certain conditions such as suffering from an “irreversible pathology” causing “intolerable suffering” and that he had the capacity to make “free and informed decisions.”
My biggest fear is I will not be able to die.
A similar case took place on the other side of the Atlantic, in Peru, where euthanasia is punishable by up to three years in prison. In February 2021, Ana Estrada became the first person to be granted the right to die in the South American country, after a judge decriminalized the practice specifically for her, El Periodico reports.
The 44-year-old woman has been diagnosed at 12 with polymyositis, an incurable and degenerative disease that weakens her muscles and forces her to stay in bed most of the time. Although the judge refused Estrada’s request to order the Health Ministry to prepare a directive for other similar cases, some hope the ruling will constitute a step toward the legalization of euthanasia in the near future.
Battles over wording of laws
While euthanasia and assisted suicide seem to gain ground in several countries, the procedures are far from widespread and some are still hesitant to legalize them.
In January 2021, Portugal’s parliament voted to legalize euthanasia, setting the country on its way to becoming the seventh in the world to allow the procedure. But last November, Portuguese President Marcelo Rebelo de Sousa vetoed the bill for the second time after already refusing to sign a first draft earlier this year, Diario de Noticias reports.
The leader criticized the wording of the proposed law, saying it was too imprecise when it came to the justification of assisted suicide. The legislation has since been shelved until the next elections in January 2022, during which a new parliament will be chosen.
In South Africa, Suzanne Walter, a palliative care specialist, and her patient Diethelm Harck, who have both been diagnosed with terminal diseases, are seeking the legal right to choose assisted dying when their illnesses will become unbearable. They pleaded their case before the Pretoria High Court in early 2021, with Harck saying: “my biggest fear is that when my love of life reaches the stage of fearing life, I will not be able to die.”
While the case is still under review, the Health Professions Council of South Africa (HPCSA) and the Ministers of Health and Justice are all opposing a potential legalization of euthanasia, with the HPCSA arguing it could open the door to potential abuse.