The right to let go with dignity | Edward Zammit Lewis

The right to medically assisted termination of life raises a number of legal and ethical issues that are controversial. It is intended to allow terminally ill patients who are enduring unbearable pain and suffering, the right to die with dignity.

In the European Union this right is recognised in the Netherlands, Belgium, Luxembourg, Spain, Portugal, Germany and Austria. France is currently discussing a similar bill and this in a highly politically charged environment due to harsh opposition from the far right. The Terminally Ill Adults [End of Life] Bill is being currently debated in Westminster for England and Wales, whilst in Scotland a similar bill has already received general approval from MPs. Countries which do not recognise the right, sometimes have policies against the commencement of prosecutions in particularly pitiful human circumstances.

The issue of euthanasia has been brewing on the back burner in Malta for some time. In 2021, I had discussions with then president of the Labour Party and friend, Daniel Micallef, who is a firm believer in such a law, to push the issue forward. The matter, however, had not been mentioned as a commitment in the 2017 Labour Party electoral manifesto and we were practically on the eve of a general election. Subsequently, the Labour Party made a commitment in its 2022 electoral manifesto to launch a public consultation on the introduction of assisted voluntary euthanasia.

The PL has kept its commitment and I thank my colleague Rebecca Buttigieg for involving me in the drafting of the White Paper. I commend her for the mature and organised way the public consultation process is being conducted.

I am in favour of a law that gives a person the choice to obtain medical assistance to die. The proposal is to make this available to adults who are in a terminal stage of a serious and incurable medical condition, which is inflicting physical suffering the patient cannot bear. However, any law, must take a strict and regulated approach and provide effective checks and balances.

I am not surprised with the position taken by the Catholic Church. Its position is in accordance with its consistent teachings and doctrine. However, it is the obligation of government and legislators to legislate for all and make available such a right to anyone of age who wants to avail themselves of it.       

The request for euthanasia will be examined by three medical practitioners one of whom will have to be a specialist in the treatment of the medical condition to which the patient is subject. These shall enquire whether the patient’s request is clear, informed, persistent and well considered.

The national health system will offer the patient any palliative care as may be available, if the patient so desires. The existence of such a law does not mean that government is not to keep investing in palliative care. Government invests tens of millions of euros in palliative care and should maintain the momentum, more so if such a law is introduced.

The medical practitioners shall draw up a report on the patient’s state of health. If, from that report, it results that the patient cannot be cured; the physical suffering cannot be controlled; the patient considers such suffering unbearable; the request of the patient was made freely, clear and made in an informed manner and was properly reflected upon; the demand of the patient is persistent; they shall send their report to a commission to be established by the law.

I believe the commission should be composed of three persons—a former member of the judiciary as chairperson, a medical practitioner of good standing and a person who specialises in moral philosophy and/or medical ethics. The commission shall within a number of days accept or refuse the report. Where the commission finds that those requirements are satisfied and accepts the medical practitioners’ report, no criminal or disciplinary proceedings may be taken against any person providing such assistance.

Finally, an important aspect of any proposed law should be that the patient may at any time withdraw the said request, even in a verbal manner.

Medical practitioners and members of the health care professions shall be free to refuse assisting someone to die but will be obliged to refer the request to another medical practitioner likely to accept to consider the request.

A medically assisted death shall be considered a natural death for all intents and purposes of law and of contract.

I support the introduction of a law intended to allow terminally ill patients who are enduring unbearable suffering to be granted the right to die with dignity.