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Euthanasia in Europe
An article from April´s issue of Etudes
Several European states have decided to legalize Euthanasia. The Netherlands in 2001, Belgium in 2002 and Luxembourg in 2009. A close analysis of legislative measures on the end of life adopted by major EU countries since 2005 “highlights unquestionable trends”, remarked Yves-Marie Doublet, professor at the Master program on “Ethics, Science, Health, and Society” of the Université de Paris Sud 11, in an article published on April’s issue of Études, magazine of politics and culture of the French Jesuits (www.revue-etudes.com[>>]).
A “twofold evolution”. On the one hand, says Doublet, far from aligning with the legalization of euthanasia, “many European states have decided to provide a juridical framework to the interruption of treatment, whilst encouraging the practice of palliative treatment”. On the other, they committed themselves to “step up the rights of patients”. It is a “twofold evolution” from which France can draw “useful tips”. It was believed that the kind of legalization of euthanasia chosen by Benelux “would been by other European countries”, but “apart from the case of the Grand Duchy of Luxembourg in 2009, since 2022 the legalization of euthanasia was not extended” across the continent. France in 2005, Germany and Italy in 2009 and in 2011, Spain in 2011 have never changed their position. “We should consider – points out the author of the Article - 470 million inhabitants, representing EU countries outside Benelux, that still haven’t legalized euthanasia, compared to 28 million people of the three States which decriminalized it. Moreover, “there is a great similarity in the legislative measures and the ‘professional’ recommendations of the main states of the European Union that have decided to give a regulatory framework to interruption of treatment”.
Commonality of opinions. A striking “commonality of opinions”, according to Doublet, especially “when analyzing the French law of April 22 2005 on the rights of patients and end of life, the so-called “Leonetti law’”. The text provides for mandatory palliative treatment and pursues two goals: that “medical treatment should not be continued with unreasonable obstinacy” if they are “useless” or “out of proportion”, and the primacy of the “right” and the “will” of the patient. German law has a similar orientation, defined through anticipated directives, adopted September 1st 2009, which in special cases allows for “euthanasia by abstention, limitation or suspension of treatment” considering the “right to autonomy of the patient”. The rules established by the Swedish agency for social affairs and health (Socialstyrelsen) reflect a similar stance by stipulating compliance with the will of the patient and the prohibition to the deliberate intention of causing the patient’s death. The Spanish draft law presented in 2011 by the then Zapatero government consists in “general directives” and provides for a national register for advanced medical directives. Stepping up the right of the patient, is Doublet’s remark, “translates the spirit of recommendation 1418/199 of the parliamentary Assembly of the Council of Europe. Of a different nature is the draft law on so-called Biological Will adopted in Italy by the Lower House in July 2011, currently up for debate in the Senate. The proposal doesn’t establish the mandatory aspect of advanced medical directives and intends to avoid therapeutic obstinacy and abandonment”.
An example of subsidiarity. “The more the advanced directives are abstract – says Doublet – the less they attract the patient’s interest and the less they are binding for the physician”. Hence the distinction shown “in the accuracy” requested in the drafting these directives by the Germans and Brits, given their generic features of the directives in Spain, Italy and France. For France Doublet hopes the issue will be “re-examined”. “This snapshot of the situation in Europe shows that countries with very different cultures, history and religions have adopted identical regulations on the interruption of treatment and end-of-life, while patients’ rights were considered binding for doctors in different ways”. For Doublet it’s positive that these States have undertaken a spontaneous initiative “without external intervention” or “principles defined at supranational European level”. “Having been developed spontaneously, without yearning to the drafting of a common law, these legislations are a wonderful example of subsidiarity that steps up their legitimacy”. At a time when “we complain for an excessive imposition of European regulations – he concludes – these rules can be translated into common viewpoints and national practices that reflect the basis of values representing the foundation and the originality of Europe”.