Ecuador's Constitutional court approves euthanasia.

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

Ecuador

This is another story of an activist court that makes a bad decision based on a hard case. 

Ecuador's Constitutional Court has approved euthanasia. As reported by DW.com on February 8, 2024:

Ecuador's high court on Wednesday decriminalized euthanasia following a landmark case brought by a terminally ill patient.

In its ruling the court said it "considers that the issue raised relates to the rights to a life with dignity and the free development of personality. Therefore, after carrying out an examination, it concludes that life admits exceptions to its inviolability when it seeks to protect other rights."

The penalty for homicide "cannot be applied to a doctor who performs an active euthanasia procedure in order to preserve the rights to a dignified life," the court added.

The ruling directed lawmakers and health authorities to establish guidelines for the practice of euthanasia.

Seven of the nine judges of Ecuador's Constitutional Court voted in favor of the decision.

The article stated that:

The lawsuit was filed last year by Paola Roldan, a patient with amyotrophic lateral sclerosis (ALS), a progressive neurological disease.

Roldan argued that people with serious and incurable diseases have the right to die with dignity.

While the court allowed lawmakers 12 months to draft the regulatory frameworks for implementation, Roldan was granted the right to an expedited process for euthanasia, albeit under strict conditions.

The court seems oblivious to the fact that they have approved of euthanasia, which means they have approved that doctors can kill their patients.

Ecuador is the second South American country where a high court decision overturned laws that protect people from homicide. Colombia, which neighbors Ecuador, had a similar high court ruling in 1997.

Switzerland assisted suicide deaths and Colombia euthanasia deaths increase in 2022.

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

Michael Cook

I was cleaning up my emails and I noticed two articles by Michael Cook, the editor of Bioedge, that were published by Bioedge on February 14 that I have not shared.

The first article reported that the number of assisted suicide deaths by the Swiss assisted suicide group Exit, increased by 15% in 2022 to 1,125 deaths. Exit is one of the main assisted suicide groups in Switzerland.

The 2022 data indicates that there were 660 women and 465 men who died by assisted suicide. 37% of the people had cancer while 76% of the assisted suicides were done in the person's home and 18.6% of the deaths occured in a nursing or retirement home.

The second article concerned the increase in euthanasia deaths in Colombia. Cook explains that there was a big increase in the number of euthanasia deaths in 2022. Even though he didn't have the complete 2022. Cook reported:

According to the right-to-die group DescLab, in 2015 there were 4 euthanasia deaths; in 2021 there were 95. In the 10 months to October 31, 2022, there were 99.

The increase has been steady: 7 in 2016; 17 in 2017; 24 in 2018; 43 in 2019; 34 in 2020, and 95 in 2021.

According to a DescLab report, between 2015 and October 31, 2022, 322 euthanasia processes have been carried out in Colombia. The last recorded year, 2022, became the period with the most medically assisted deaths. In total, 99 deaths were recorded, while in 2015, when it was regulated, there were four.

Michael Cook reported in April 2021 that the recent Colombian euthanasia bill was defeated, Colombia permits euthanasia based on a 1997 Constitutional Court decision. Cook stated:

Although Colombia is often described as a country where euthanasia is legal, the actual situation is complicated. In 1997 the country’s Constitutional Court ruled that that "the State cannot oppose the decision of an individual who does not wish to continue living and who requests help to die when suffering from a terminal illness that causes unbearable pain, incompatible with his idea of dignity". It directed the legislature to pass a law regulating the right to die.

However, more than 20 years have passed and one bill after another has failed.

Euthanasia is a form of homicide that occurs when a medical professional kills a patient after the patient requested death. Assisted suicide occurs when a medical professional writes a prescription or provides a lethal dose to a patient that they person will self-administer. Euthanasia and assisted suicide are prohibited in most countries in the world.

Colombia's Health Ministry sets euthanasia guidelines.

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

In 1997 Colombia's Constitutional Court ruled that: "the State cannot oppose the decision of an individual who does not wish to continue living and who requests help to die when suffering from a terminal illness that causes unbearable pain, incompatible with his idea of dignity".

Since that time, euthanasia has been technically legal in but rarely done in Colombia.

An article by Merco Press reports that Colombia's Health Ministry has set out guidelines for euthanasia. According to the Merco Press article:

Colombia's Health Ministry has issued Resolution 971, setting out the guidelines regarding the carrying out of euthanasia procedures, which has sparked some controversy among national lawmakers.

According to the document from the health authorities of the only country in South America so far to have legalized the right to death with dignity, the patient must make this request directly (verbal or written) or indirectly, through an advance directive document (DVA). The request must be voluntary, informed, unequivocal and persistent.

The resolution states that patients wishing to exercise their right to die with dignity will have to submit ”a clinical condition at the end of life, (...) present secondary suffering, be in a position to express the request directly.”

Once the patient makes the request, the doctor must immediately include it in the medical record and activate the interdisciplinary scientific committee that will study the request within the first 24 hours.

The document also establishes that “health providers (IPS) that have enabled the medium or high complexity hospitalization service for oncological hospitalization, institutional care for chronic patients or home care for chronic patients, that have protocols of management for palliative care, will make up within each entity a scientific-interdisciplinary committee for the right to die with dignity through euthanasia.”

The committee must study the applications within the first 10 days and will be made up of a lawyer, a doctor with the speciality of the pathology suffered by the patient and a psychiatrist or clinical psychologist, and when the committee is formed, it must be declared that none is a conscientious objector.

A bill to regulate euthanasia failed to pass in Colombia in April.

Euthanasia bill fails again in Colombia

This article was published by BioEdge on April 17, 2021

Michael Cook

By Michael Cook is editor of BioEdge

The Colombian legislature has once again failed to pass a law legalising euthanasia. Earlier this week a bill proposed by representative Juan Fernando Reyes Kuri needed to reach 85 votes in favour, but fell two votes short.

Although Colombia is often described as a country where euthanasia is legal, the actual situation is complicated. In 1997 the country’s Constitutional Court ruled that that "the State cannot oppose the decision of an individual who does not wish to continue living and who requests help to die when suffering from a terminal illness that causes unbearable pain, incompatible with his idea of dignity". It directed the legislature to pass a law regulating the right to die.

However, more than 20 years have passed and one bill after another has failed.

Supporters of the right to die are frustrated. Reyes Kuri says that he understands that some of his colleagues in this majority Catholic country are opposed for religious or ethical reasons of their own, "but we cannot allow them to continue imposing their beliefs on everyone".

Another politician supporting a right-to-die law, Senator Armando Benedetti, argues that euthanasia already exists in Colombia; it only needs to be regulated: "Why should those who do not believe in God be limited in their desire to stop living in the face of so much suffering?”

From their point of view, legislative deadlock creates uncertainty for doctors. Few are willing to offer euthanasia because, technically, it is still illegal. "There is still legal insecurity for people who decide to access this procedure and for the doctors who carry it out," says Reyes Kuri.

Opponents give the 1997 ruling a different twist. Angela Sanchez, a representative in the legislature, says that the Court declared that the right to a dignified life implies dying with dignity -- which is why Colombia needs more support for palliative care. Representative Edwin Arias says that the Court only sought to create an exception to the crime of mercy killing and not the legalisation of euthanasia.

Michael Cook is editor of BioEdge