Exploring the Reform of Euthanasia Practices in Spain
The Ministry of Health has recently engaged in discussions with autonomous communities to revamp the Manual of Good Practices on Euthanasia, with mental illness potentially being included as a valid reason for requesting euthanasia.
The draft of the Organic Law on the Regulation of Euthanasia (LORE) suggests that mental illness should not be excluded as a reason for seeking euthanasia. It allows individuals suffering from unbearable mental illness to access the Aid to Dying Benefit (PAM) on par with those battling somatic diseases.
Moreover, the proposed reform stresses the need for a thorough psychopathological evaluation to determine individuals eligible for PAM due to severe mental disorders.
However, the reform also emphasizes the importance of excluding individuals with mild or moderate depression or anxiety, as these conditions can often be treated effectively and improved.
In 2023, three key modifications were introduced to the Manual of Good Practices, such as revising the right of pharmacists to object to euthanasia and establishing the role of a reference nurse in euthanasia.
ALS Patients and Legal Implications
Meanwhile, the European Court of Human Rights recently ruled against allowing assisted suicide for a patient with Amyotrophic Lateral Sclerosis (ALS). A Hungarian lawyer, Dániel Karsai, challenged Hungarian law by seeking permission for assisted suicide due to his debilitating illness.
The court’s decision highlighted the distinction between withdrawing life support and facilitating assisted suicide, with an emphasis on informed consent in end-of-life care.
Bioethical Analysis
The evolving legal landscape in Spain, including the consideration of mental illness in euthanasia cases, raises concerns about the slippery slope phenomenon observed in countries legalizing euthanasia. The gradual expansion of eligibility criteria, including minors and mentally ill patients, challenges the core principles of medical ethics.
While respecting patients’ autonomy is vital, applying euthanasia to individuals with compromised decision-making capacity, such as children or those with ALS, raises ethical concerns. Palliative care remains a crucial aspect of end-of-life care, focusing on holistic patient well-being.
Ultimately, the trend towards broader euthanasia applications underscores the need for robust ethical guidelines and a steadfast commitment to upholding human dignity and rights in healthcare practices.
Julio Tudela – Ester Bosch – Bioethics Observatory – Life Sciences Institute – Catholic University of Valencia
