[WATCH] I’m suffering - why can’t I choose to leave this life? | Humanists Malta

Should those who want it have the right to make their own choices, to be in control of their own lives, and particularly their final moments?

We know, from those who have faced incurable suffering, about the indignity, often pain, and sometimes tedium, they endure in an existence which has lost all worth; about their wish to make their own decisions and have a peaceful, rather than a prolonged and dehumanising death.

For some, quality of life unquestionably trumps quantity of it. Personal stories can illustrate this. Sam Debattista, who is living with Huntingdon’s disease, has condemned the lack of any political action in support of the right to choose to end pointless suffering. For a number of years, ALS sufferer Joe Magro has campaigned for this right. And, while he would not seek assisted dying for himself, fellow-ALS sufferer Bjorn Formosa has expressed sympathy for those who need and want it.

Many of us will never want or need to make this choice. But some of us will, and both we and our doctors are bound by the current law in Malta, denying us the right to act in accordance with our conscience and desires. Justice and compassion surely require the ending of suffering if that is what the patient wishes and needs. Asking for a right to assisted dying does not deny the value of life; rather, it reflects that, for some, life is too valuable to be lived without meaning and hope.

Public opinion on assisted dying has shifted over recent years. A survey in April this year showed that 61% of respondents agreed with the right to end life for those who are incurably suffering, with only 19% opposed, although only 31% would choose to end their own life to avoid suffering, and 28% said they would prefer to endure the pain and prolong life as much as possible. This illustrates the difference between people’s personal acceptance of assisted dying, and their attitude to its availability for others with different views.

Of course, one of the major questions is who should be eligible: Only the terminally ill? Those with longer life expectancy but unbearable suffering? Should there be an age threshold? This must be part of a national debate which includes the expertise of medical/psychiatric, medical ethics, and legal specialists.

We would suggest that, as a minimum, any request for assisted dying must be provably voluntary, explicit, recorded and witnessed, informed, consistent over a specified period, and revocable at any time and in any manner. More than one doctor should be required to give written agreement about the patient’s condition and their mental capacity to make decisions. In all cases, the process should be monitored by a central body established for the purpose.

More than 350m around the world already have a legal right to die. Regimes differ. A UK House Of Commons Committee Report in February 2024 identified 17 jurisdictions (not necessarily countries) where assisted dying is legal only on the basis of a terminal diagnosis; nine where it is legal on the basis of much wider criteria such as intolerable suffering (physical or mental); and four where it is not illegal or there is ongoing case law. But, to put that into context, the latest statistics we know of are that in 2018, in countries where assisted dying was legal, it was responsible for only between 0.3% and 4.6% of deaths, over 70% of which related to cancer.

This article is the first in a series on assisted dying. We use the term ‘assisted dying’ rather than ‘euthanasia’, to cover only voluntary active euthanasia and assisted suicide - actions at the request of the patient.

Our hope is to raise awareness that assisted dying is an option that you or your loved ones might one day need to consider. Although many are adamant they would not want the choice for themselves, others do want a free choice, leading to death with dignity, which is denied them by current Maltese law. There are many issues to discuss, which we will address in our articles. Our overall aim is to call for understanding and tolerance, and a carefully monitored regime which respects individual wishes, while protecting all involved.