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THE euthanasia dilemma includes a lot of ambiguities and uncertainties. It starts with the definition of euthana- sia, a word of Greek origin—'eu' which means 'good' or 'well' and 'thanatos', which means 'death'. Euthanasia can be translated into 'good death' or 'dying well'. Multiple euphemistic words and state- ments may be used to refer to eutha- nasia, which, however, might be mis- leading to make it more acceptable and agreeable. These include assisted dy- ing, merciful death, physician assisted death. Even international organisations such as the World Health Organisation and World Medical Association, have differing definitions. Nonetheless, all definitions or euphemisms agree that euthanasia involves a form of death un- der the pretence of mercy. So far, there is no strong evidence that euthanasia is painless because of the na- ture of the paralytic drugs, which can be used both in euthanasia and when the death penalty is meted out in countries where it is legal. But while the death penalty is meant to be a punishment, euthanasia is meant to offer relief from unbearable suffering. The paralytic drugs which are given in high doses in both situations are in- tended to paralyse the individual—the person will be unable to move even a muscle or make any facial expression or show any outward sign of pain. But this does not mean such individuals are free from pain and suffering. On the contrary, some argue it may be a very painful death. The methodology used in execution of euthanasia varies between the limited number of the countries in the world that practice it and, in some centres, where oral doses of the drugs are used, it might take up to 100 hours until death will be achieved. In fact, there are cases of patients who regained consciousness after the procedure was finalised. This shows there is no defini- tive predictability in the procedure. Ob- viously, this lack of important informa- tion related to euthanasia raises a lot of moral, social, ethical and legal question marks. Euthanasia not widespread In a public debate on topics like eutha- nasia it is an ethical and moral obliga- tion to present all the known facts about the subject in a transparent and easily understandable way. It is important that all people in society, regardless of their level of education, are able to discuss the matter with adequate awareness and eventually will be capable to hold an opinion with an acceptable level of confidence. One of the basic facts which everybody has the right to know is that the adop- tion of euthanasia as a legal practice is only available in a very small number of countries across the world. This num- ber might constitute only around 6% of total countries in the globe. This situa- tion materialised after about 90 years of the official euthanasia debates kicking off. The first euthanasia societies were established in the UK and America in 1930s. Euthanasia is not part of the law or has been rejected by the absolute ma- jority of humans on our planet. International organisations like the United Nations (UN) and World Health Organisation (WHO) recognise the right to life and the best possible palli- ative care; however, they leave it up to the member states to determine in their laws whether they should also include euthanasia. The World Medical Asso- ciation (WMA) firmly opposes eutha- nasia and emphasises that respect be maintained for human life. The conditions The proposal put forward by the Mal- tese government lays down the precon- ditions that have to be fulfilled before a person can avail themselves of assisted dying: The patient has to be terminally ill and given a lifespan of less than six months; they must be fully informed; mentally capable; and the decision must be entirely voluntary. It is important to delve into these con- ditions. A prognosis is defined medically as a doctor's estimate of how long a patient is expected to live with a particular illness. The prognosis of terminally ill patients can never be definitive, so, re- lying on the prognoses to justify eutha- nasia is ambiguous and uncertain. Secondly, the mental status of the in- dividual who is terminally ill, will be negatively impacted by multiple factors including depression, frustration and side effects of the drugs being adminis- tered. These factors will inevitably reduce the mental capacity of such individuals significantly so they will not be able to take any critical and significant deci- sions in general and specifically, make the grave decision to end their life. Specialists who care for terminally ill people, know from real life that there are family members who express an in- terest in the patient's inheritance and complaining of the cost of the health care. In these circumstances it can become quite difficult to determine whether someone is being pressured to choose euthanasia voluntarily. Sacred human life There are those who argue that bodi- ly autonomy and human rights presup- pose an individual has the right to die. This statement is commonly used but without adequate understanding of the terminology. A right is a moral claim. Humans do not have a claim on death. Rather, death has a claim on them. So, this means, the right to die does not exist. In fact, Article 6 of International Covenant on Civil and Political rights (ICCPR) stipulates that every human being has the inherent right to life. Even when presented in a voluntary manner, the legalisation of euthanasia is in direct violation of these provisions. Any human life is considered to be sa- cred and of infinite value. This is always true regardless how ill, weak, disabled the person is in the eyes and minds of a materialistic, consumerist societies. The duty of any respectable society is to preserve all forms and phases of life in its holistic meaning and give con- sistently the maximum possible needed palliative care with great love and com- passion. Slippery slope A potential risk of legalising eutha- nasia is the slippery slope effect. The Netherlands, where euthanasia was first Reflections on the euthanasia dilemma Samir AbouHussein Medical consultant 10 maltatoday | WEDNESDAY • 30 JULY 2025 OPINION