Issue link: https://maltatoday.uberflip.com/i/1524716
10 OPINION maltatoday | WEDNESDAY • 31 JULY 2024 IT had long been coming, and it is now out. A growing majority of Maltese are in favour of eu- thanasia. This latest controversial sub- ject follows right on the heels of other broken taboo subjects such as divorce, IVF, abortion, same-sex marriages and the decriminalisation of cannabis use. There seems to be a gradual shift in the attitude of a mi- nority in the medical commu- nity as well as the lay public towards greater acceptance of euthanasia as an option for the care of the terminally ill and dying. A few within the med- ical community see certain similarities in terms of goals and aims between euthanasia and palliative care and, thus, propose that euthanasia be an option or choice for difficult palliative care cases. Some even go as far as to suggest that euthanasia and palliative care be part of the continuum of care for terminally ill patients. When palliative medicine fails to fully control pain and suffer- ing for the patient, euthanasia can be the logical next step in the continuum of care. Can it be that the rationale for legalising euthanasia is flawed, that it goes against the funda- mental principles of medicine in general and is incompatible with the practice of palliative medicine? Euthanasia merits a nation- al, mature discussion with all stakeholders taken on board be- fore proceeding to put the mat- ter to the vote. Any discussion must consider the issue from all possible perspectives, not least moral, religious and legal. I believe that we are still far from considering having a robust and strict legislative framework to regulate assist- ed suicide, even though some- thing similar somehow found its way into the Labour Party's electoral manifesto. In the meantime, we are sure to hear and read contrasting views from all sides. There will be those superficial and hollow arguments in favour, based on the stereotypical 'my body, my choice' formula. Expect the Maltese Church to put forth its vehemently contrary views. The PN has, more than once, publicly asserted its stand against euthanasia. Genuine and convinced pro-euthanasia exponents rest their case on their determina- tion to resort to mercy killing. They have no control over how they arrive in the world, but at the end of life, they should have control over how they leave it, without in any way debasing the value of life. They are not afraid of being dead. They only ask for dignity in dying. Such determination requires great courage and an unwavering, strong will. Euthanasia advocates will be advancing at least three alleg- edly legitimate and justifiable reasons for its legality. First, possibly, it is needed. This is 'the compassion argument'. Supporters of assisted suicide believe that allowing people to 'die with dignity' is kinder than forcing them to continue their lives with suffering. Secondly, there will be those who want it. This is known as 'the autonomy argument'. Some believe that every patient has a right to choose when to die. If autonomy is the issue, why do we not respect every disa- bled or suicidal person's wish for death? Regardless of their health condition or life expec- tancy, there are always people who wish to die for reasons that seem compelling to them. Many of these people undergo great suffering that is compa- rable to the pain of a terminal illness and may afflict them for a much longer time while being less amenable to treatment by drugs like morphine. Most of them are clinically depressed, but so are most suicidal people with terminal illnesses. Why continue to insist on suicide prevention and enhancing the rights of the disabled for all these other people while of- fering suicide assistance to the terminally ill? Thirdly, some believe that it can be controlled. I would de- scribe this as 'the public poli- cy argument', assuming that assisted suicide can be safely regulated by government leg- islation. Taking the argument further, if we are to assert that patients should have a right to die, would that impose on doctors a duty to kill, thus restricting their autonomy? Even putting aside the Christian morality upon which the Constitution and our nation's culture are based, the notion of forced eu- thanasia would contradict the long-held body of medical eth- ics to which all Maltese doc- tors must adhere. Who should decide if eutha- nasia is to be carried out, espe- cially if the persons in question are not in a fit state to make their own decision for reasons of illness or injury? Shouldn't certain fundamen- tal conditions be met, such as that the patient be of a sound mind, suffering from an incur- able or terminal illness, expe- riencing unbearable suffering and uncontrollable pain? Yes, dear readers, there is much more to debating this delicate subject than meets the eye. Admittedly, euthanasia will emphasise the personal deci- sion in a way that was blissfully alien to the whole problem of dying in former times. Changing the law to allow euthanasia or assisted suicide Euthanasia: Another taboo broken Mark Said is a veteran lawyer Mark Said