The ethical failure of denying euthanasia | Daniel Schembri

Daniel Schembri is a physiotherapist working in the public service

In recent weeks, we've heard people, including a well-known doctor, argue that assisted voluntary euthanasia (AVE) should remain illegal, because, after all, “suicide is still legal”. Few arguments are as disgusting and offensive as equating suicide and euthanasia.

Suicide is often panic driven and done out of despair or untreated mental illness. It leaves behind trauma, confusion, and grief. I have seen patients survive their attempts and live with permanent disabilities. AVE, on the other hand, is controlled, effective and humane. It is a decision supported by medical and psychiatric assessments, reflection and informed consent.

Telling terminal patients that we don’t need AVE legislation because they can always commit suicide is the very opposite of compassion. It is an insult to those already enduring suffering, be it physical or psychological.

It is obvious that such loud opponents of AVE are not driven by a concern for vulnerable people being in some way coerced. What motivates them, is perhaps the inability to allow choice, and their fixation to hijack other people’s suffering to validate their own beliefs and control issues.

They will never admit this, but coercion already exists in a system banning AVE. By keeping euthanasia illegal, and denying terminal patients all options, we’re forcing them into medication side effects, invasive procedures, lack of independence or the consequences of stopping treatment—we are coercing them to follow a path that does not include the AVE option. Caring for the vulnerable necessitates that we give them more choices, not less.

Yet, in spite of having such a coercive system which ignores requests for a peaceful death, the anti-choice crowd were on the forefront to scream “coercion of the vulnerable!” as soon as the consultation process was launched. The hypocrisy is staggering.

Some have expressed concerns that legalising AVE opens the floodgates to abuse. But if it is not safe to have a tool because it can be abused, then palliative care would have been outlawed years ago. Doctors already control morphine doses, sedation and decisions to withhold interventions. An unscrupulous doctor, perhaps in quiet agreement with family members, already has the power to end a life. But we do not shut down palliative care—we keep it regulated. The same logic applies to AVE. You do not ban tools for fear of abuse. Instead, you build systems and legal frameworks to ensure they are used ethically. 

The scaremongering around AVE is shameless. We’ve heard that legislation will turn hospitals into killing factories, or that people will start killing their parents for inheritance. Yet, anyone who read the safeguards in the White Paper should know that such scenarios are heavily protected against.

Now here’s the part no one wants to say out loud: Keeping AVE illegal is not a neutral position. It’s not some safer “default.” It’s an act of coercion against those who want the option. It is legally mandated suffering that has normalised lack of choice and dignity in death.

In a scenario where the best palliative care has its limits, even if only a handful of eligible patients want AVE, that right matters. Such people need to be given a voice, and I feel obliged to help in doing so. Human rights are not based on majorities, otherwise minority rights would not exist. You don’t have to like euthanasia, or choose it for yourself, but I can never agree with anyone being against choice and denying AVE to someone who needs it.

The compulsion to exert control on other people’s lives is not ethics. It is coercion in disguise. This is not a debate about life or death. It is a debate about who gets to decide—the person living through their suffering, or the rest of us watching from a privileged safe distance.