Spain passes euthanasia, assisted suicide law

Euthanasia Medical syringe Credit sfam photo Shutterstock CNA sfam_photo/Shutterstock.

Spain's legislature passed a law Thursday to legalize euthanasia and assisted suicide. Catholic leaders have decried the measure as "a defeat for all", which abandons those who suffer.

The Congress of Deputies, the lower house of Spain's legislative body, approved the law March 18 by a vote of 202 in favor, 141 against, and two abstentions. All that remains for the law to go into effect is its promulgation in the Official Bulletin of the State; it is expected to take effect in June.

Patients who can request euthanasia must be adult Spanish nationals or legal residents who suffer from "a serious and incurable disease or a serious, chronic and incapacitating condition."

The law defines such condition as a having "limitations that directly affect physical autonomy and the activities of daily life, such that the patient can't fend for himself, as well as the ability to communicate with and relate to others, and that are associated with constant and intolerable physical or mental suffering for the patient with the certitude or great probability that such limitations will persist over time without the possibility of a cure or appreciable improvement. On occasion, it can mean absolute dependence on technological life support."

A serious and incurable disease is defined as  "one that by its nature causes constant and unbearable physical or psychological suffering without the possibility of relief that the person considers tolerable, with a limited life prognosis, in a context of progressive frailty."

The law requires the National Health System to provide euthanasia, and while individual doctors can claim conscientious objection, medical facilities, even private, cannot object as institutions. Conscientious objectors will be listed on a registry.

It requires that before requesting euthanasia, the patient must be informed in writing of his medical condition, and of alternative courses of action and palliative care.

The law stipulates the patient has to have "voluntarily and in writing formulated two requests," with a fifteen calendar day interval in between.

In the event that the patient is physically unable to sign the request, it may be dated and signed by a third person in the patient's presence.

If there is no person who can submit the request on behalf of the patient, "the attending physician may submit the request for euthanasia."

A request for euthanasia must be approved by two doctors and an oversight board.

The law also states that "the death resulting from providing aid in dying shall be considered a natural death for all purposes."

The Spanish Bishops' Conference stated in a commentary on the law that "euthanasia may be practiced in a very wide range of situations."

The bishops pointed out that euthanasia could be carried out "unrelated to objective situations of uncontrolled and uncontrollable agony and pain."

Bishop Luis Javier Argüello Garcia, auxiliary bishop of Valladolid and secretary general of the Spanish Bishops' Conference, urged doctors who don't want to participate in euthanasia to exercise conscientious objection.

He also cautioned against a defeatist attitude, seeing the new law as an opportunity "to promote a culture of life and to take concrete steps to promote a living will or advance declarations that make it possible for Spanish citizens to express in a clear and determined way their desire to receive palliative care," instead of assisted suicide or euthanasia.

Bishop Argüello urged doctors "not to induce death to alleviate suffering," but instead to treat the patient with "tenderness, closeness, mercy, encouragement, and hope for those people who are in the final stage of their existence, perhaps in moments of suffering that need comfort, care and hope."

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The bishops' conference also issued a guide for patients to create a living will that "specifies that appropriate treatments be administered to alleviate suffering," but excluding euthanasia.

Those opposed to the law have pointed out that what the country needs
instead of euthanasia is access to palliative care. Out of an estimated 120,000 patients in need of palliative care, 50% do not have access.

The bill was introduced by the Spanish Socialist Workers' Party, and in February 2020 the Congress of Deputies approved it for consideration. Debate began Sept. 10.

Spanish prime minister Pedro Sanchez, leader of the Spanish Socialist Workers' Party, tweeted shortly after the March 18 vote, "Today we have become a country that is more humane, fairer and freer."

The conservative Popular Party and the far right party Vox have opposed the law. Vox has said it will challenge the law in Spain's Constitutional Court.

The Bioethics Committee of Spain had unanimously rejected the underlying principles behind the bill in its October report.

The 12-member CBE, which is responsible for issuing reports on matters with relevant bioethical implications, unanimously reached the decision to advise the government that the proposed law is not valid from an ethical point of view.

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Euthanasia is also legal in Belgium, Canada, Colombia, Luxembourg, the Netherlands, and the Australian state of Victoria.

Portugal's legislature recently legalized euthanasia, but the country's Constitutional Court blocked the law and President Marcelo Rebelo de Sousa vetoed it.

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