Why is the law leaving me to suffer needlessly? | Humanists Malta

As it stands in Malta, the law withholds the right to assisted dying from those who would freely choose it, rather than endure an existence with no meaning or value.

Patients have the right to refuse treatment (if capable of doing so); and palliative sedation, and withdrawal of treatment, are legal, but active euthanasia is not. So medical professionals must, understandably, be wary of taking any action which might be seen as active euthanasia, however clearly a patient might request it.

Some argue that the best palliative care is the alternative to assisted dying, or that palliative and end of life care would be negatively impacted by its introduction. We do not believe that good quality palliative care is inconsistent with assisted dying, nor a sufficient alternative. While palliative care has a crucial role at the end of life, it is not the answer for those who have a clear and positive wish that their body should not be kept functioning when they are without independence, quality of life, and dignity.

The UK report mentioned in our first article concluded that “In the evidence we received we did not see any indications of palliative and end of life care deteriorating in quality or provision following the introduction of [assisted dying]”. It quoted one expert witness “Almost 95% of the patients I have cared for have also been receiving excellent quality Palliative Care; their reasons for seeking [assisted dying… are not due to lack of access to services… it is existential distress: a loss of the sense of self, dignity, autonomy, meaning, or purpose in life, that causes a kind of hopelessness particularly resistant to palliative interventions.”

On a related subject, while suicide itself is not a crime in Malta, assisting a suicide is punishable by up to 12 years in prison. It is unclear how far ‘assistance’ in a completed suicide would be judged as criminal here. As a result, loved ones of those who would choose assisted suicide risk imprisonment for even passive participation, based wholly on compassion, such as being present when a suicide died, or accompanying them to an institution abroad. We do not even know whether a ‘Dying Declaration’ before a notary, including confirmation that the suicide’s decision is well-considered, autonomous, and at least not influenced by the ‘assistant’, would be likely to be a successful defence if a prosecution is brought. Surely this law needs clarification.

Active euthanasia and assisted suicide are not considered human rights under international treaties, nor by the European Court of Human Rights. But as early as 2005, UNESCO’s Universal Declaration on Bioethics and Human Rights stated “The autonomy of persons to make decisions, while taking responsibility for those decisions and respecting the autonomy of others, is to be respected”. It rightly added that “For persons who are not capable of exercising autonomy, special measures are to be taken to protect their rights and interests”, with which we wholly agree.

International human rights legislation recognises the right to life, but that does not imply a duty to live under any circumstances. Again, we simply ask for a carefully monitored choice for those who need it.

This article is the last 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 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.