Assisted Dying: It’s a Pandora’s box, but we are late to the debate | Andrew Azzopardi

What a complex and moral concern. My initial take on this issue is that we’ve been postponing it for far too long, and, unfortunately, it has rarely featured on our national agenda, aside from the occasional fleeting mention. 

The debate on euthanasia, from where I stand, hinges on complex questions of personal rights, ethical responsibilities, and societal values.

Finding common ground requires careful consideration of both individual suffering and the broader implications for society. 

Opponents argue that intentionally ending a life, even to alleviate suffering, is fundamentally wrong. 

Added to this, the religious argument slips in, suggesting that it could undermine society's commitment to the sanctity of life. 

Moreover, the potential for abuse is a serious concern. So, any move towards legislating in that direction needs to be airtight, especially when it comes to vulnerable groups (or groups we have labelled as vulnerable), such as the elderly or the disabled community, who may feel pressured to choose euthanasia—whether due to societal attitudes, coercion, or family members advocating for the alleviation of pain.  

This could also potentially lead to a "slippery slope", where euthanasia is expanded to less severe cases or non-consenting individuals.

Safeguards may not be foolproof, leading to misuse or non-voluntary euthanasia. 

Legalising euthanasia could also shift the role of doctors, changing their focus from preserving life to ending it. This may erode trust in the medical profession among parts of the Maltese community that still follow the Church’s teachings on the matter, with some arguing that it undermines the Hippocratic Oath. 

Unusually, my stance is somewhat on the fence on this topic. On the one hand, I believe that extreme forms of pain, where no medical solutions exist, should be given an outlet to relieve oneself from that suffering—something I would want for myself. 

On the other hand, the truth is that advancements in palliative care can provide effective pain management and emotional support for terminally ill patients, offering a humane alternative to euthanasia. Palliative care is becoming an increasingly effective science, and both the methodology and investment have grown exponentially, which is why the focus should be on improving end-of-life care rather than normalising euthanasia. Moreover, our legislators do not provide me with the serenity that a mature discussion and strong enough legislation would be implemented.   

The flaws in both abortion and cannabis laws highlight how lawmakers often feel compelled to legislate not based on rational, scientific, or moral reasoning but in response to public pressure, swinging between opposing positions depending on the outcry at the time. 

To conclude, I believe we need to explore regulating euthanasia. This practice should be allowed under strict conditions, namely, consent from the patient, psychological evaluation, and oversight by an independent panel. Cultural and religious sensitivities need to also be respected, as should diverse cultural beliefs and views on the morality of euthanasia. Finally, a focus on individual cases and ethical deliberation can help balance compassion with caution, and this is in line with the debate to introduce a living will. 

So, yes, it is definitely opening Pandora’s box, but hell, aren’t we late in putting this matter on the agenda? 

Andrew Azzopardi is a professor and former Dean of the Faculty for Social Wellbeing at the University of Malta