Assisted suicide is already a reality in some parts of the world and provokes ethical and legal debates – Saúde

RIO – A farewell message posted on the French actor’s social networks Alain Delon86 years old, brought up again a topic considered taboo in many countries: the suicide watched. One of the icons of cinema in the 20th century, Delon had already expressed himself for the freedom to choose to die instead of living a limiting aging. The debate attracts supporters of the measure and critics worried about the repercussions.

In 2019, the actor suffered two strokes and today he lives with limitations, but he is not admitted to a hospital. Yet he seems to have decided that there is no point in prolonging existence anymore. “My life was very beautiful, but also very difficult,” he wrote on his Instagram account, which was later deactivated. “I never liked getting old; all the pains and trials that I have to face daily leave me paralyzed.”

The actor must undergo assisted death in the Switzerland, where he lives, and the practice has been legal since 1942. One of his sons has already challenged the information. In Brazil, the practices of assisted suicide, as well as euthanasia (see the difference between the practices on the next page) are considered crimes, which adds to the moral condemnation promoted by religious regarding the practice.

Euthanasia (when a doctor administers a lethal drug to a patient) is considered simple homicide. Assisted suicide (when the patient himself takes the drug indicated to die) is a crime against life, described in article 122 as the act “of inducing or instigating someone to commit suicide or providing assistance to do so”. THE Life Appreciation Center (CVV)through the number 188, provides emotional support and suicide prevention 24-hour voluntary and free of charge.

In 2018, the topic had already gained space in the international media because of the assisted death of the British botanical laureate David Goodall, aged 104, in a clinic in Switzerland. Like Delon, Goodall did not suffer from any terminal or incurable illness. Until 2016 he worked as a research associate at the University of Perth, at Australia, where he taught his entire life. But he said he had made the decision because of the growing reduction in his independence.

“My skills have been on the wane for a year or two; my vision for more than six years,” she told reporters on the eve of her death as she checked into the clinic where she would voluntarily end her life. “I don’t want to continue life. I am happy to have the chance, tomorrow, to close it.” Goodall ordered the traditional British dish fish and chips as his last meal. He set off listening to his favorite composer, Beethoven.

Alain Delon is a longtime activist for the cause of assisted suicide. He campaigned for passage of the law to guarantee the practice in France. When he underwent a procedure for the strokes he suffered in 2019, he said: “Aging sucks! You lose your face, you lose your eyesight.” In an interview last year, he stated: “Euthanasia is the most logical and natural thing. From a certain age and stage in life, we have the right to calmly depart this world, without the support of a hospital or life support devices”.

In most parts of the world, however, measures like this are not reality. Assisted suicide is legal in countries such as the Netherlands, Belgium, Luxembourg, Germany, Spain, Canada, Colombia and some states in the United States. But it can only be applied to cases of terminal or incurable diseases, which generate unbearable suffering for the patient. In Switzerland, these conditions are not necessarily prerequisites, and the interpretation of “unbearable suffering” is somewhat broader.

“(Death) is not something simple anywhere”, explains the doctor Gérson Zafalon Martins, from the Brazilian Society of bioethics. “In all these countries, the requirements are similar, the patient needs to suffer from a terminal illness, have an unbearable suffering with no prospect of improvement. That is, there must be a justification, and the patient must be lucid, in psychiatric conditions to decide. It is also worth remembering that we are not talking about an obligation, but a right.”

A survey carried out by the specialist shows that, in 2020, in Netherlands, for example, 2,901 requests for euthanasia were made; of which only 899 were granted. Most involved terminal cancer patients with advanced ages. “It’s a cultural issue, you can’t get away from it, death is a big taboo for us”, says lawyer Luciana Dadalto, specialist and author of the book Vital Testament. “We think dying is the worst thing that can happen to a person. And, as we think so, we do everything to prevent it from happening. We don’t have an education for death, an understanding that we are finite beings, that mortality is part of our history.”

This approach to the topic finds resistance in the religious environment. THE Catholic church condemns assisted suicide. “What the Church believes is that there will always be hope and meaning for a person’s life as long as he or she is alive,” said the coordinator of the Pontifical’s Nucleus of Faith and Culture. Catholic University (PUC) of São Paulothe biologist and sociologist Francisco Borba Ribeiro Neto.

“As medical science evolves, we are always better able to allow people to enjoy life even with many limitations resulting from illness and old age, and they would always have to invest in guaranteeing that hope, that quality of life, that possibility of continuing to contribute to social life, even with very serious health limitations. It is important to underline that we are not defending the idea that people should continue to suffer, but the idea that they continue to have the capacity to be happy and to contribute to the happiness of others, even in a very difficult situation.”

Assisted suicides can happen at home or in a hospital. The patient is prescribed a dose of a lethal drug, usually given orally. The suicide is filmed so that the police can attest that it was a strictly personal decision.

For advocates of assisted suicide, the legislation is considered an important step because it supports the legality of the act, guaranteeing, for example, the receipt of life insurance by the family. “It is not about encouraging suicide”, clarified judge Diaulas Costa Ribeiro, from the Court of justice from the Federal District, specialist in medical bioethics and member of the End of Life Commission of the Federal Council of Medicine (CFM). “We are talking about very sick patients, with no prognosis, who suffer from physical pain; this patient renounces to continue life in this state.”

The legislation is important because it supports the legality of the act, guaranteeing, for example, the receipt of life insurance by the family. “But in Brazil this is a crime. The country’s religious trait is very strong, and, in fact, a religious command is repeated in the legislation. Criminal law should not serve religion,” says Ribeiro. In the country, the Federal Council of Medicine (CFM) authorizes doctors to interrupt the treatment of terminally ill patients as long as this is the person’s express wish. The practice is called orthothanasia and, because of the name, tends to cause confusion. But this is a completely different practice from euthanasia or assisted suicide.

In fact, it is opposed to dysthanasia, or therapeutic obstinacy. This occurs when there is no longer a chance of cure for the patient, but, even so, he is kept alive by devices, and receives treatments that will not change his prognosis.

The American Medical Association (AMA) comments in its code of ethics against assisted suicide. The entity points out that the attitude is incompatible with the role of the doctor as a professional who promotes medical treatment. Instead of helping death, the association emphasizes that the physician’s role is to support patients with incurable diseases, respecting their autonomy and providing pain control and comfort mechanisms.

“Doctors, in general, feel very pressured by the patient’s family, especially with that speech of ‘while there is life, there is hope’”, says doctor Gérson Zafalon Martins. If the patient is lucid, his word is enough to express his will regarding the treatment. The so-called living will is a legal way of recording the patient’s will and is valid even if he is unconscious.

“My will basically says this, that when I have an incurable, irreversible disease, I don’t want extraordinary measures, I want them to respect the time of my death, without prolonging my suffering, without artificial life support, without invasive techniques, without medicines. to heal just a part of my body”, says lawyer Luciana Dadalto. “I want to be seen as a person, not just a part.”

The whole discussion is still very incipient in Brazil and is restricted to the academic environment. There is no news of people who have tried judicially to guarantee assisted suicide. “There is no demand because the subject is not discussed”, summarizes Diaulas Costa Ribeiro.

Euthanasia

The word comes from the Greek and means “good death”. Euthanasia consists of the application of a lethal dose of some medicine by a doctor who is following the treatment of a terminally ill patient, with no prospect of improvement.

assisted suicide

In assisted death, it is the patient himself who takes the lethal medicine. It is used most often also by terminally ill patients suffering from incurable diseases.

orthothanasia

In this case, it is not a matter of advancing death. But neither does it postpone it. Practice indicates that, in terminal cases, with no prognosis of cure, useless therapeutic efforts should not be applied.

dysthanasia

The practice is also called therapeutic obstinacy. When there is no prognosis of cure for the patient, but even so, his life is artificially prolonged with devices and medications.

About Abhishek Pratap

Food maven. Unapologetic travel fanatic. MCU's fan. Infuriatingly humble creator. Award-winning pop culture ninja.

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