Where is the debate on euthanasia going in Latin America?

Illustration by Connectas. Used with permission.

This article was written by Carlos Gutiérrez and published in CONNECTAS on February 23, 2024. An edited version is republished in Global Voices under a media partnership.

The attendees will never forget that soccer match on Saturday, February 10, between Deportivo Independiente Medellín (DIM) and Santa Fe. And not because of what happened on the field, but because of what was experienced in the stands. Young Sebastián Pamplona came to the stadium to fulfill his last wish: to see DIM, his favorite team from his birth country Colombia, play for the last time before undergoing euthanasia due to his terminal illness. Thousands of attendees and players chanted his name, in deeply moving moments.

#Sports | Sebastián Pamplona, ​​the Medellín fan who will undergo euthanasia and said goodbye at the Atanasio Girardot

Colombia is the first country in Latin America to decriminalize euthanasia. The law permitted it in 2015, for patients with terminal illnesses. A medical professional must practice the procedure with prior authorization from the Scientific-Interdisciplinary Committee to Die with Dignity.

The debate over the decriminalization and regulation of euthanasia has once again made the news in Latin America: at the beginning of February the Constitutional Court of Ecuador decriminalized active euthanasia, after a 42-year-old woman, Paola Roldán, began an organized movement on social media in August 2023 to request the legalization of assisted death.

Ecuador decriminalized euthanasia in a historic ruling on the case of Paola Roldán. This makes the country the ninth in the world to decriminalize assisted death.

Three years ago Paola was diagnosed with amyotrophic lateral sclerosis and has been immobilized in bed for more than six months with no possibility of improvement. In these circumstances, she put together a team of lawyers to petition the court for her right to a dignified death. In the process she became a symbol of the fight for the decriminalization of euthanasia, not only in Ecuador but throughout Latin America.

Although etymologically euthanasia means “good death” or “die well,” currently it refers to ending the life of a person who has an incurable and irreversible condition. It involves the use of painless means to avoid the prolongation of serious physical suffering.

Globally, only nine nations have managed to decriminalize and legalize the procedure. The Netherlands started the trend in April 2002. A month later, Belgium also legalized euthanasia; in 2009 Luxembourg joined. In 2016, Canada joined and New Zealand in 2020, while Spain legislated on it in July 2021 and Portugal in 2023. In Australia, it is only allowed in the state of New South Wales, which authorized it in 2022.

Europe, Holland, Belgium and Luxembourg allow euthanasia. In the United States it is legal only in 5 states. While in Canada both assisted suicide and #euthanasia became legal in 2016. #DignifiedDeath pic.twitter.com/jdTxDODfL1

In the United States, between 1997 and 2017, ten states legalized assisted suicide for people over 18 years of age and with a life expectancy of no more than six months. In assisted suicide there is no third person, as in euthanasia. It is defined as the action of a person who suffers from an irreversible disease to end his or her own life.

In 2022, Colombia decriminalized assisted suicide for people with serious or incurable illnesses. That same year Víctor Escobar, a 60-year-old transporter, became the first Colombian to receive euthanasia without suffering from a terminal illness. He had suffered cardiovascular accidents, had obstructive pulmonary disease, and hypertension.

In December, the Cuban National Assembly of People's Power approved a new law that “recognizes the right of people to access a dignified death, through the exercise of self determination for the end of one's own life, which may include the limitation of therapeutic effort, continuous or palliative care and valid procedures that end life.” This rule, however, will only come into force when the legislature approves regulations for its application.

Eneyda Suñer, a Mexican academic at the Western Institute of Technology and Higher Studies (ITESO), thinks that euthanasia should be legalized and not just decriminalized, because this would open “the door to having serious, strict and careful protocols. Otherwise, it continues to be done surreptitiously, without care and without protocol.”

In Mexico, the General Health Law prohibits euthanasia, assisted suicide and mercy killing. However, there is an anticipated will, a legal instrument through which a person who suffers from a terminal illness or foresees such a situation can plan the treatment and care they wish to receive in their last days.

· It is a right to self-determination that respects the will of the sick, to avoid prolonging their life at the cost of pain and suffering https://t.co/NTCLHHzsGC pic.twitter.com/O4m9zq2adc

One of the arguments in favor of legalization is the right to decide about one's own life. “In both medically assisted suicide and euthanasia, I am not causing any damage to the rights of third parties,” says Marina Arias, lawyer for the Ministry of Public Defense in Paraguay.

Discussions around euthanasia are full of complexities and myths. “Topics that have to do with morality are often taboo. There is abortion, euthanasia, surrogacy, homosexual relations…,” says Suñer. From their point of view, the law in favor of euthanasia should exist because it is ultimately about living better.

Lawyer Arias maintains that when legalizing, it would be necessary to defend above all the right to autonomy. That is, “To what extent do we decide about ourselves?” she asks. She argues that, since there are laws that criminalize euthanasia and assisted suicide, it is the State that decides when each person can dispose of their body. She also advocates that, when legislating on euthanasia, mental illnesses be considered.

In an interview for the Uruguayan radio program “In Perspective,” the Spanish oncologist and palliative specialist Enric Benito spoke about the experience of Fernando Sureda, former manager of the Uruguayan Football Association. In 2018, after being diagnosed with amyotrophic lateral sclerosis, he began requesting that Uruguayan law allow him to be euthanized. He never accomplished his goal. Due to the pandemic, Benito accompanied Sureda virtually during his last days.

Most of the experts interviewed for this article agree that many of the controversies on the subject occur among healthy people and on a theoretical level. Not many studies are done with people who are experiencing terminal illnesses. “People who really want euthanasia are not in a position to make statements, to sign documents. Normally they realize that they want euthanasia when they are in a terminal state and in a lot of suffering,” says Suñer.

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